Heavy metal toxicity

What sources contain arsenic?

Wood preservatives, insectisides , coal combustion, water in third world countries

Acute Symptoms of Arsenic toxicity ?

gastroenteritis
Hypotension
Metabolic acidosis
garlic breath
Rice water stool

Chronic symptoms of Arsenic toxicity?

Pallor
Alopecia
Rain drop skin pigmentation
Stocking glove neuropathy
Myelosuppression

Antidote used for arsenic toxicity?

Dimecaperol
Penicillamine

Symptoms of acute iron poisoning in children?

Sever GI distress
Necrotizing gastroenteritis
Bloody diarrhea, hematemisis, dyspnea, shock and coma

Treatment of Iron poisoning?

Gastric aspiration
Deferoxamine

Classic sources of lead?

Tap water
Leaded paint chips in old houses

Symptoms of chronic lead poisoning?

microcytic Anemia
Lead colic (gastroenteritis)
Lead neuropathy
Lead nephropathy
Hepatitis
Mental retardation
Decreased fertility

Options for treatment of chronic lead poisoning?

Succimer PO
Dimercaprol

What type of anemia is caused by lead toxicity? What must it be differentiated from?

sideroblastic anemia
Must rule on chronic alcoholism
Mus rule out B6 deficiency

What two enzymes of the heme synthesis pathway does lead interfere with?

D-ALA synthase
protopophyrin 9 conversion to heme

Sources of mercury?

Batteries
Salt amalgams
Dyes
electroplating

Acute symptoms of mercury poisoning?

Inhaled: Pneumonitis, dyspnea chest pain
Ingested: Hemorrhagic , Gastroenteritis, tubular necrosis and shock

Chronic symptoms of mercury poisoning?

CNS effects
Parasthesia
Ataxia
Auditory and visual loss
Loosening of teeth

Treatment of mercury poisoning?

Dimercaperol
Succimer PO

How does Calcium EDTA work? Use?

Binds metals via hydroxyl groups
Used for lead and cadmium detox

How does dimercaperol work? Use?

Lead, mercury, arsenic, cadmium

How does succimer work? Use?

Binds metals through sulfhydryl and hydroxyl
Used for Lead, mercury, arsenic and cadmium

USe of penicillamine?

COpper ,lead, mercury and arsenic

What is trientene used for?

Copper detox

What is deferoxamine used for?

Iron chelation