Lead Flashcards

1
Q

T/F: Lead is not readily degraded in the environment

A

TRUE

it is persistent

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2
Q

T/F: Lead is readily absorbed and metabolized

A

False

only about 1-2% if absorbed from the GIT because it forms insoluble compounds

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3
Q

What pH conditions favor lead dissolution?

A

Acidic

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4
Q

What sources of lead are pets exposed to?

A

Most common source is lead based paints

A thumbnail sized chip of paint could have 50 - 200 ppm lead in it

other: batteries, putty, galvanized wire, lead shots, linoleum

**areial emission from combustion of leaded fuel, insecticides/herbicides

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5
Q

What is more readily absorbed, organic lead or inorganic lead?

A

Organic lead bc it is lipid soluble

Can be absorbed by the skin and accumulated in fat

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6
Q

What is organic lead used for?

A

Anti-knocking agents in gasoline products

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7
Q

Where is inorganic lead found?

A

in dyes, paints, and pesticides

Poor absorption due to low water solubility

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8
Q

What is the lowest lethal dose of lead in dogs?

A

191 mg/kg

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9
Q

What animals are most vulnerable to lead toxicosis related deaths?

A

Waterfowl
ingest spent pellets or lost fishing sinckers

Birds shot with lead pellets can become a source of secondary poisoning for other animals

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10
Q

What two ions will lead displace in the blood?

A

Ca and zinc

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11
Q

What dogs are most sensitive to lead poisoning?

A

Puppies are more sensitive than adults due to the permeability of the BB

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12
Q

What are the routes of lead absorption?

A

Dermal - organic based is absorbed better this way than inorganic

Inhalation and absorption via lungs - arial spraying of lead based pesticides (not in US)

**Ingestion* - oral absorption is poor, but increased absorption in GIT due to acidic pH

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13
Q

What molecules will decrease the absorption of lead in the GIT?

A

Calcium, zinc, and protein

Lead is absorbed by active transport using the same carrier protein as calcium

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14
Q

If a patient is deficient in ____, then lead is more readily absorbed

A

Vitamin D
Calcium
Zinc
Iron

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15
Q

In what animals is GIT absorption of lead greatest?

A

Immature animals

up to 50% compared to 5-15% in adults

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16
Q

Does lead cross the BBB or placental barrier?

A

YES

crosses BBB in young animals

17
Q

What does lead bind to for transport in systemic circulation?

A

Binds to erythrocyte membrane (60-90% RBC binding depending on species)

18
Q

Lead can stay in the soft tissue for ____ weeks

19
Q

Where can lead be stored in the body for years?

A

In the active bone matrix compete with Ca

larger amounts in young (83-95%) vs old (70-75%)

Biologically inactive in the bone but can be released back into systemic circulation due to fracture etc

20
Q

What chelating liver protein involved in cellular detoxification of inorganics, will sequester lead when it is in high concentrations?

A

Metallothionein

21
Q

Where is lead excreted?

A

Primarily through the urine

Bile and milk as well

22
Q

What are the target tissues of lead toxicosis?

A

GIT, blood, CNS

23
Q

What is the MOA of lead toxicosis?

A

Interferes with biological structure and function

Can substitute for Ca, Zn, Mg, Fe

Competes with Ca in the bone and alters Ca movement across membranes –> Alters structure of the cerebral endothelium - edema

24
Q

What is the MOA in chronic lead toxicosis?

A

Chronic low exposures - inhibites heme synthesis that leads to anemia (also decreased RBC lifespan)

inhibits regulation of Ca

Alters release of neurotransmitters (dopamine, acetylcholine, GABA)

**breakdown of BB via injury to endothelial cells and alteration of the microvascular systems

25
What GIT signs are associated with lead toxicosis?
Oral exposure: anorexia, salivation, vomiting, "lead colic", dhr or constipation *rare - megaesophagus
26
What are the hematological clinical signs associated with lead toxicosis?
Clinical signs related to anemia Basophilic stippling of erythrocytes Antemortem: Whole blood concentration >0.35 ppm = lead toxicosis Postmortem: Liver and kidney >10ppm = lead toxicosis
27
What CNS signs are associated with lead toxicosis?
CNS inhibition of neurotransmitters = CNS hyperexcitability OR CNS depression *depends on which neutrotransmitters are spontaneously released OR blocked Dopamine, Ach, GABA
28
What lesions are associated with lead toxicosis?
non specifc, may find lead objects in the GIT Histo: cerebral cortical necrosis and poliomalacia in cattle *acid fast eosinophilic intranuclear inclusion bodies in renal tubular epithelium or hepaticytes
29
What abnormalities may be present in the UA of an animal with lead toxicosis?
Porphyria: due to lead inhibition of porphobilinogen synthase hemoglobinuria - increased heme
30
What kind of anemia is associated with lead toxicosis?
Can be regenerative or non regenerative (poor bone marrow response)
31
What radiographic changes can be noted in an animal with lead poisoning?
Metaphyseal sclerosis in young animals with chronic lead toxicosis "lead line"
32
T/F: Lead lines represent lead deposits in the bone
FALSE sclerosis of the metaphysis Lead inhibits normal remodeling of the long bones
33
What is the antemortem specimen of choice for lead toxicosis? What value is diagnostic?
Whole blood >90% of circulating lead is bound to RBCs Blood lead > 0.4ppm with clinical signs = diagnostic or > 0.6ppm without clinical signs (PM - test liver, kidney, GIT)
34
T/F: Lead toxicosis should always bc a ddx when a dog or cat presents with unexplained GI signs and abdominal pain
TRUE
35
Is activated charcoal recommended for lead ingestion?
NO does not bind well to heavy metals
36
What tx is available for lead toxicosis?
Stabilize and supportive care first. Eliminate Pb: wash haircoat, cathartics, gastric lavage Chelation therapy: use of chelating agents to detoxify - by forming multiple bonds with metal ions rendering them inactive and ready for excretion
37
What potential side effects are associated with chelation therapy for the tx of lead toxicosis?
Can result in hypocalcemia and kidney damage
38
What chelating agents are used for tx of lead toxicosis?
Calcium disodium EDTA - most commonly used - primary concern is renal injury * binds to other minerals so concurrent supplementation is recommended * until it is all chelated, mobilized Pb in the circulation can redistribute in order to achieve equilibrium - re-toxification
39
What is the prognosis for lead toxicosis?
Good in animals with mild to moderate signs that are treated promptly and appropriately Guarded to poor if animals are showing severe CNS signs