Pbt: Heavy Metals And Chelators

Front 1

Cu serves an essential functions in ____ and ____.

Back 1

Ceruloplasmin
Superoxide dimutase

Front 2

Cobalt is essential in ____.

Back 2

Vitamin B12 coenzymes.

Front 3

Zn is essential in ____.

Back 3

Zinc finger (gene transcription).

Front 4

Which form of Pb is absorbed through the following routes?
A. GI tract
B. Respiratory tract
C. Dermal absorption

Back 4

1. Metal
2. metal fumes
3. organic alkyl lead

Front 5

What is the target organ of Pb poisoning?

Back 5

CNS

erythrocytes
soft tissues (brain, kidney, liver, muscle)
bone

Front 6

A kid presents with fluid-brain edema, encephalopathy, wrist drop, and anemia. Blood smear shows hypochromaic microcytic anemia and basophilic strippling. What do the symptoms indicate? What are some ways to treat it?

Back 6

Lead poisoning of 70ug/dl or higher.

Treat: chelate therapy at >45 ug/dl)
1. Dimercaprol: IM
2. Succimer: oral
3. EDTA: IV

Front 7

A guy presents with abdominal pain, diarrhea, and wrist drop. Blood smear shows hypochromaic microcytic anemia and basophilic strippling. What do the symptoms indicate? Can you use chelating therapy for him?

Back 7

Lead poisoning of 100ug/dl or higher.

Yes. Should treat with chelators when >50-60 ug/dl.

Front 8

What are some sources of As poisons?

Back 8

1. insectisides, fungicides, rodenticides.
2. Fowler's solution
3. Arsphenamine (treatment for syphilis.

Front 9

Which of the following As inhibit pyruvate dehydrogenase by binding to -SH groups?
A. As+3
B. As+5
C. As-3
D. AsH3

Back 9

A

Front 10

Which of the following As substitutes for phosphate in glycolytic and respiratory pathway, uncouples phosphorylation?
A. As+3
B. As+5
C. As-3
D. AsH3

Back 10

B

Front 11

Acute or chronic As poisoning?
Nausea, vomit, congestive cardiomyopathy, encephalopathy.

Back 11

acute

Front 12

Acute or chronic As poisoning?
Anemia, anorexia, hyperkeraosis, raindrop pattern of hyperpigmentation.

Back 12

chronic

Front 13

Chelating therapy is not useful in which kind of poisoning?

So what treatment should be given instead?

Back 13

As gas poisoning.
intensive supportive care, blood transfusion, hemodialysis.

Front 14

Which of the following poisons would not show basophilic strippling of erythrocytes in blood smear?
A. Pb
B. As
C. Hg

Back 14

C.

Front 15

How is elementary Hg absorbed?

Back 15

Liquid form is well absorbed through inhalation.

Vapor form can cross BBB.

Front 16

How is inorganic Hg absorbed?

Back 16

oral: cause GI toxicity.
dermal

Front 17

How is organic Hg absorbed?

Back 17

cross BBB: cause neural toxicity.

Front 18

Which two forms of Hg cross BBB?

Back 18

elementary and organic

Front 19

Pneumonitis, pulmonary endema, hemorrhage, gastroentgeritis, renal failure are acute toxicities of ___.

Back 19

Hg

Front 20

neuropsychiatric disturbance (memory loss, insomnia, fatigue), depression, CNS parasthesia, mental retardation are chronic toxicities of ___.

Back 20

Hg

Front 21

What chelators can be used to treat Hg poisons?

Back 21

Dimercaprol and succimer for acute toxification.

Succimer and D-pencillamine, DMPS for chronic toxification.

Front 22

What chelators can be used to treat Cu poisoning?

Back 22

Pencillamine
Trientine
tetrathiomolybdate

Front 23

Name a chelator that treats Fe poisoning.

Back 23

Deferoxamine

Front 24

_____ cause hypertension whereas ____ cause hypotension.

Back 24

Dimercaprol
Deferoxamine

Front 25

Which chelator is the water soluble form of dimercaprol?

Back 25

succimer

Front 26

Which chelator cause kidney injury and Zn loss?

Back 26

EDTA