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ABT Test > Chapter 19 - Metal Toxicology > Flashcards

Chapter 19 - Metal Toxicology Flashcards

0
Q

A property of metals of great toxicological significance is…

A. They all exhibit a U-shaped dose-response curve

B. They have no threshold for toxicity

C. They are less toxic as cations

D. They accumulate in the biosphere

A

D. They accumulate in the biosphere

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1
Q

A chemical property of elemental metals that makes them particularly troubling to biological systems is…

A. They are essentially non-biodegradable

B. They mostly convert to cations with +1 charge

C. They form insoluble salts

D. They form alloys

A

A. They are essentially non-biodegradable

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2
Q

All of the following are chemical ways that metals cause toxicity except…

A. Binding to sulfhydryl groups

B. Mimicry of essential metals

C. Acting as semiconductors and short-circuting nerve impulses

D. Acting as catalytic centers for redox reactors in the generation of ROS.

A

C. Acting as semiconductors and short-circuting nerve impulses

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3
Q

One drawback in using hair samples as a tissue to measure metal exposure is that…

A. Metals can be removed from hair by shampoo

B. Hair can be contaminated by external sources of metals

C. Workers who spend most of their day outside in cold weather will have less hair metal deposition compared to office workers

D. Older, graying hair has less reliable deposition rates than younger hair

A

B. Hair can be contaminated by external sources of metals

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4
Q

Many human metabolites of arsenic are…

A. Methylated

B. Sulfated

C. Glucuronidated

D. Acetylated

A

A. Methylated

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5
Q

A recent source of cadmium exposure is…

A. Batteries

B. Synthetic motor oil

C. Dental fillings

D. Crack cocaine

A

A. Batteries

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6
Q

The metal salt of lowest toxicological significance is…

A. Vanadium pentoxide

B. Titanium dioxide

C. Thallium sulfate

D. Uranyl chloride

A

B. Titanium dioxide

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7
Q

In occupationally exposed adult workers, OSHA standards require the maintenance of blood levels below…

A. 10 ug/dl

B. 20 ug/dl

C. 40 ug/dl

D. 80 ug/dl

A

C. 40 ug/dl

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8
Q

All of the following may result from lead toxicity to the kidney except…

A. Hypouricemia

B. Aminoaciduria

C. Glycosuria

D. Phosphaturia

A

A. Hypouricemia

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9
Q

Which of the following is least useful in a medical evaluation of a lead-exposed worker?

A. Blood pressure measurement

B. Blood lead level

C. Serum creatine phosphokinase

D. Microscopic urinalysis

A

C. Serum creatine phosphokinase

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10
Q

Alcohol intake may influence metal toxicity by all of the following except…

A. Altering diet

B. Induction of CYP450 2E1

C. Reduction of essential mineral intake

D. Altering hepatic iron deposition

A

B. Induction of CYP450 2E1

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11
Q

All of the following are adaptive responses to metal toxicity except…

A. Increased albumin synthesis

B. Lead-inclusion bodies

C. Overexpression of metallothionein

D. Metal-induced oxidative stress response

A

A. Increased albumin synthesis

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12
Q

Which of the following metal-medicinal use pairs is incorrect?

A. Platinum-cancer chemotherapy

B. Gold-arthritis

C. Aluminum-dementia

D. Lithium-mania

A

C. Aluminum-dementia

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13
Q

Environmental arsenic exposure occurs mainly through…

A. Industrial air pollution

B. Automobile exhaust

C. Cigarette smoke

D. Drinking water

A

D. Drinking water

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14
Q

A gas with a similar toxicologic effect to arsine is…

A. Chlorine

B. Ethane

C. Stibine

D. Ammonia

A

C. Stibine

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15
Q

The combination of nickel with carbon monoxide produces the respiratory tract toxicant…

A. Nickel carbonate

B. Phosgene

C. Stilbene

D. Nickel carbonyl

A

D. Nickel carbonyl

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16
Q

Fluorosis refers to symptoms secondary to excess fluoride intake in…

A. Liver and kidney

B. Heart and skeletal muscle

C. Teeth and bones

D. Central and peripheral nervous system

A

C. Teeth and bones

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17
Q

Acrodynia is a disease in children caused by exposure to…

A. Arsenic

B. Lead

C. Cadmium

D. Mercury

A

D. Mercury

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18
Q

Mercury is deposited in bodies of water and the atmosphere…

A. Through volcanic emissions

B. Through industrial emissions

C. Through rainwater

D. All of the above

A

D. All of the above

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19
Q

Stainless steel welding exposes workers to all of the following except…

A. Chromium

B. Sulfur dioxide

C. Nickel

D. Manganese

A

B. Sulfur dioxide

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20
Q

Pigmentation of the skin and eyes is asso w/ prolonged exposure to…

A. Silver

B. Thallium

C. Germanium

D. Cesium

A

A. Silver

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21
Q

Selenium deficiency is asso w/ …

A. Seizures

B. Peripheral neuropathy

C. Cardiomyopathy

D. Renal failure

A

C. Cardiomyopathy

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22
Q

All of the following are asso w/ beryllium exposure except…

A. Lung cancer

B. Acute chemical pneumonitis

C. Chronic granulomatous disease

D. Peptic ulcer disease

A

D. Peptic ulcer disease

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23
Q

All of the following are true regarding mercury exposure except…

A. Sea mammals have higher levels than herbivorous fish

B. Drinking water is a significant source of exposure

C. Concentrations in marine life can be 80,000x higher than in surrounding water

D. Cooking fish does not lower the level of methylmercury.

A

B. Drinking water is a significant source of exposure

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24
Q

Which of the following statements is true?

A. Methylmercury does not cross the placenta

B. methylmercury is metabolized to mercuric ion by the placenta

C. Methylmercury is present in fetal brain at 50% of the conc. in the maternal blood

D. Methylmercury is present in the fetal brain at 5-7 times the conc. in maternal blood

A

D. Methylmercury is present in the fetal brain at 5-7 times the conc. in maternal blood

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25
Q

Which of the following metal-commercial product pairs is incorrect?

A. Ziconium-deoderants

B. Tungsten-detergents

C. Selenium-dandruff shampoos

D. Aluminum-antacids

A

B. Tungsten-detergents

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26
Q

A metal that substitutes for calcium in bone is…

A. Lithium

B. Cesium

C. Silver

D. Strontium

A

D. Strontium

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27
Q

Which of the following is considered a metalloid?

A. Beryllium

B. Bromine

C. Boron

D. Tungsten

A

C. Boron

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28
Q

Potassium deficiency can result from all of the following except…

A. Vomiting

B. Renal failure

C. Diarrhea

D. Diuretic use

A

B. Renal failure

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29
Q

All of the following are true regarding exposure of metallic sodium or potassium to air except…

A. Superoxides may form

B. Explosions can occur

C. Particles embedded in skin or eyes should be irrigated with large amts. of water

D. Dermal and ocular burns can lead to liquification necrosis

A

C. Particles embedded in skin or eyes should be irrigated with large amts. of water

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30
Q

Acute gastrointestinal symptoms with gastrointestinal hemorrhage followed by cardiovascular collapse, renal failure, jaundice and delayed peripheral neuropathy describes the acute toxicology of…

A. Mercury

B. Lead

C. Arsenic

D. Cadmium

A

C. Arsenic

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31
Q

Colicky abdominal pain, headache, fatigue, encephalopathy are asso w/ acute exposure to…

A. Inorganic mercury

B. Lead

C. Mercury vapor

D. Cadmium

A

B. Lead

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32
Q

All of the following are true of thallium except…

A. Toxicity may result from mimicking sodium ion

B. Prussian Blue is an antidote

C. It is one of the most toxic metals

D. Significant exposure can result in dermal, cardiac or neural toxicity

A

A. Toxicity may result from mimicking sodium ion

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33
Q

All of the following are true of the toxicity of tin except…

A. An outbreak of toxicity occurred in France during the 1950’s

B. Inorganic tin cmpds. can be relatively neurotoxic

C. Organic tin cmpds. can be very neurotoxic

D. Inorganic cmpds. are better absorbed than organic tin cmpds.

A

D. Inorganic cmpds. are better absorbed than organic tin cmpds.

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34
Q

All of the following are true of uranium cmpds except…

A. Renal toxicity is common

B. Acute radiation toxicity is more of a concern than chemical toxicity

C. They accumulate in bone

D. Urine uranium levels correlate with acute exposure

A

B. Acute radiation toxicity is more of a concern than chemical toxicity

35
Q

All of the following are true of zinc except…

A. It induces metallothionein

B. Overdose is more of a problem than deficiency

C. It is essential for human growth and development

D. Zinc oxide is a cause of ‘metal fume fever’

A

B. Overdose is more of a problem than deficiency

36
Q

Dialysis dementia may be due to excess…

A. Potassium

B. Phosphate

C. Aluminum

D. Urea

A

C. Aluminum

37
Q

Bismuth salts are used medically to treat all of the following except..

A. Diarrhea

B. Peptic ulcer

C. H. Pylori gastritis

D. Inflammatory bowel disease

A

D. Inflammatory bowel disease

38
Q

A metal similar to mercury in that it is liquid at or near RT is…

A. Bromine

B. Gallium

C. Antimony

D. All of the above

A

B. Gallium

39
Q

All of the following are manifestations of lithium toxicity except…

A. Tremor

B. Liver necrosis

C. Diabetes insipidus

D. Renal failure

A

B. Liver necrosis

40
Q

Hereditary hemochromatosis causes…

A. Increased intestinal absorption of iron

B. Decreased bilary excretion of iron

C. Decreased renal excretion of iron

D. Increased sensitivity of liver cells to normal levels of iron

A

A. Increased intestinal absorption of iron

41
Q

There is experimental evidence that iron may play a part in the development of…

A. Atherosclerosis

B. Osteosarcoma

C. Adrenal insufficiency

D. Hypothyroidism

A

A. Atherosclerosis

42
Q

Metal-induced Parkinson’s disease is caused by…

A. Magnesium

B. Molybdenum

C. Manganese

D. Selenium

A

C. Manganese

43
Q

Garlic breath is asso. w/ all of the following except…

A. Selenium

B. Cyanide

C. Arsenic

D. Thallium

A

B. Cyanide

44
Q

Trivalent chromium has been used medicinally to…

A. Treat depression

B. Improve sleep

C. Lower blood pressure

D. Decrease insulin resistance

A

D. Decrease insulin resistance

45
Q

Excess copper ingestion in humans has been asso. w/ …

A. Liver necrosis

B. Hypertension

C. Pancreatitis

D. All of the above

A

A. Liver necrosis

46
Q

All of the following are true in Wilson’s disease except…

A. There is impaired biliary excretion of copper

B. Serum ceruloplasmin is elevated

C. Serum unbound copper levels are elevated

D. There are characteristic corneal findings

A

B. Serum ceruloplasmin is elevated

47
Q

Menke’s disease is characterized by…

A. Increased liver copper

B. Copper deficiency in the brain

C. Bronze skin

D. None of the above

A

B. Copper deficiency in the brain

48
Q

All of the following are true of iron deficiency except…

A. It is the most common nutrient deficiency in the world

B. The major presentation in young children is seizure disorder

C. It is asso. w/ adverse pregnancy outcomes in adults

D. It causes microcytic anemia

A

B. The major presentation in young children is seizure disorder

49
Q

Symptoms of acute iron overdose include…

A. Seizures, polyuria, bradycardia

B. skin rash, respiratory alkalosis, bleeding

C. Parathesias, muscle weakness, tremors

D. Nausea, abdominal pain, metabolic acidosis

A

D. Nausea, abdominal pain, metabolic acidosis

50
Q

The form of mercury that has the highest gastrointestinal absorption is…

A. Elemental

B. Mercurous

C. Mercuric

D. Methylmercury

A

D. Methylmercury

51
Q

A majortoxicokinetic issue with methymercury is…

A. Enterohepatic recycling

B. Storage in bone

C. Renal failure-induced decreased renal excretion

D. Saturation of P-glycoprotein exporter

A

A. Enterohepatic recycling

52
Q

The major target organ of inorganic mercury is…

A. Brain

B. Peripheral nerve

C. Kidney

D. Adrenal gland

A

C. Kidney

53
Q

The major tragedy of the Minamata, Japan methylmercury exposure was…

A. Lifetime seizure disorder in exposed adults

B. Developmental disabilities in offspring of exposed pregnant mothers

C. Intellectual deficits in exposed children

D. High incidence of lymphoma in all exposed geoups

A

B. Developmental disabilities in offspring of exposed pregnant mothers

54
Q

Excessive cobalt ingestion in humans has been asso. w/ …

A. Congestive heart failure

B. increase in red blood cells

C. Goiter

D. All of the above

A

D. All of the above

55
Q

Lead inhibits the activity of…

A. Aspartate transferase

B. Ferrochelatase

C. Beta-glucuronidase

D. Superoxide dismutase

A

B. Ferrochelatase

56
Q

Lead in blood is mostly…

A. In neutrophils

B. Bound to albumin

C. In erythrocytes

D. Unbound

A

C. In erythrocytes

57
Q

Biochemical effects of lead include all of the following except…

A. Inhibition of delta-aminolevulinic acid dehydrogenase

B. Increase in protophorphin IX in erythrocytes

C. Decrease in urine delta-aminolevulinic acid excretion

D. Chelation of zinc by erythrocytes

A

C. Decrease in urine delta-aminolevulinic acid excretion

58
Q

The most common adverse reaction to nickel is…

A. Contact dermatitis

B. Gout

C. Hypertension

D. Pulmonary edema

A

A. Contact dermatitis

59
Q

All of the following are true of methylmercury except…

A. It is produced by biomethylation reactions in oceans

B. It can significantly bioconcentrate

C. The major human health risk is neurotoxicity

D. It can be destroyed by cooking at 160F

A

D. It can be destroyed by cooking at 160F

60
Q

All of the following are true of arsenic except…

A. It is strongly positive in the Ames test

B. Neurologic symptoms after acute exposure are delayed by 1 to 2 wks

C. It is asso. w/ peripheral vascular disease

D. Skin cancers frequently occur on palms of hands and soles of feet

A

A. It is strongly positive in the Ames test

61
Q

Beryllium exposure is asso w/ ….

A. Hemolytic anemia

B. alopecia

C. Parkinson’s disease

D. Granulomatous lung disease

A

D. Granulomatous lung disease

62
Q

All of the following are true of cadmium exposure except…

A. Food is a principal source of exposure

B. It causes proximal tubular dysfunction

C. It can be asso w/ bone deformities

D. Dialysis is effective treatment

A

D. Dialysis is effective treatment

63
Q

The toxicity of hexavalent chromium is thought to result from…

A. Binding to the estrogen receptor

B. Free radical generation

C. Precipitation in the kidney

D. Blockade of sodium channels

A

B. Free radical generation

64
Q

Lead and cadmium may both be asso w/ all of the following except…

A. Proximal tubular renal dysfunction

B. Hypertension

C. Pancreatitis in humans

D. Osteoporosis

A

C. Pancreatitis in humans

65
Q

Baldness is asso w/ …

A. Thallium

B. Gold

C. Silver

D. Cobalt

A

A. Thallium

66
Q

All of the following are factors that influence metal toxicity except…

A. Age at exposure

B. Valence state of metal

C. Blood glucose level

D. Concurrent alcohol or smoking

A

C. Blood glucose level

67
Q

Which of the following has the shortest biological half-life?

A. Cadmium in the kidney

B. Lead in bone

C. Lithium in blood

D. Gold in synovial fluid

A

C. Lithium in blood

68
Q

All of the following are correct metal-binding protein pairs except…

A. Transferrin-iron

B. C-reactive protein-lead

C. Metallothionein-cadmium

D. Metallothionein-zinc

A

B. C-reactive protein-lead

69
Q

Fingernails and hair are good biomarkers for exposure to…

A. Arsenic

B. Magnesium

C. Potassium

D. Boron

A

A. Arsenic

70
Q

The triad of symptoms traditionally asso w/ chronic inhalation of mercury vapor are…

A. Baldness, skin rash, tremors

B. erethism, diarrhea, weight loss

C. Psychosis, hematuria, jaundice

D. Tremors, gingivitis, erethism

A

D. Tremors, gingivitis, erethism

71
Q

Peripheral neuropathy is not a common manifestation of toxicity with…

A. Lead

B. Arsenic

C. Cadmium

D. Cisplatin

A

C. Cadmium

72
Q

Cr+3 is asso w/

A. Chromate mimics

B. Gout

C. Essential for glucose metabolism

D. Present in thioredoxin

A

C. Essential for glucose metabolism

73
Q

Phosphate ion

A. Arsenate mimics

B. is essential for glucose metabolism

C. Present in pesticides

D. Gout

A

A. Arsenate mimics

74
Q

Zn

A. Present in thioredoxin

B. Indian childhood cirrosis

C. Deficiency causes acrodermatitis enteropathica

D. Toxicity treated with amiloride

A

C. Deficiency causes acrodermatitis enteropathica

75
Q

Sulfate ion

A. Arsenate mimics

B. chromate mimics

C. Present in thioredoxin

D. Self-tolerance

A

B. chromate mimics

76
Q

Ceruloplasmin

A. Indian childhood cirrosis

B. gout

C. Hepcidin modulates absorption

D. Converts Fe+2 to Fe+3

A

D. Converts Fe+2 to Fe+3

77
Q

Cd

A. Self-tolerance

B. Hepcidin modulates absorption

C. Contact dermatitis

D. Chromate mimics

A

A. Self-tolerance

78
Q

Co

A. Gout

B. present in pesticides

C. Self tolerance

D. Causes increased erythropoiesis

A

D. Causes increased erythropoiesis

79
Q

Fe

A. Present in thioredoxin

B. Hepcidin modulates absorption

C. Causes increases erythropoiesis

D. Arsenate mimics

A

B. Hepcidin modulates absorption

80
Q

Mn

A. Converts Fe+2 to Fe+3

B. Essential for glucose metabolism

C. Present in pesticides

D. Toxicity treated with amiloride

A

C. Present in pesticides

81
Q

Se

A. Arsenate mimics

B. Chromate mimics

C. Toxicity treated with amiloride

D. Present in thioredoxin

A

D. Present in thioredoxin

82
Q

Ni

A. Contact dermatitis and epigenetic carcinogen

B. Gout

C. Mimics potassium

D. Self tolerance

A

A. Contact dermatitis and epigenetic carcinogen

83
Q

Li

A. Mimics potassium

B. toxicity treated with amiloride

C. Present inpesticides

D. Chromate mimics

A

B. toxicity treated with amiloride

84
Q

Mo

A. Self tolerance

B. Gout

C. Indian childhood cirrosis

D. Mimics potassium

A

B. Gout

85
Q

Cs

A. Present in pesticides

B. Present in thioredoxin

C. Mimics arsenate

D. Mimics potassium

A

D. Mimics potassium

86
Q

Cu

A. Self tolerance

B. arsenate mimics

C. Indian childhood cirrosis

D. Essential for glucose metabolism

A

C. Indian childhood cirrosis

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