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TAS Accidents and Poisoning ✅ > Lead Poisoning ✅ > Flashcards

Lead Poisoning ✅ Flashcards

1
Q

How can childhood exposure to lead occur in developed countries?

A
  • Environmental sources in the home, e.g. leaded paint
  • Lead contaminated dust and soil
  • Water contaminated by lead pipes
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2
Q

Is significant toxicity from lead common in developed countries?

A

No, it’s rare

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3
Q

Where is lead a much more significant problem?

A

In the developing world

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4
Q

What is the most common source of lead poisoning in the developing world?

A

Lead-glazed ceramics

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5
Q

Why is lead glazed ceramics a leading cause of lead poisoning in the developing world?

A

Their production is often a home-based industry in which children are actively employed

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6
Q

What are the other sources of lead in developing countries?

A
  • Leaded petrol
  • Groundwater contamination from mining, smelting, and battery factories
  • Exposure to other occupational sources through parents
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7
Q

What are the toxic effects of lead related to?

A

Dose

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8
Q

What is a normal concentration of lead in the blood?

A

<0.5

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9
Q

What is the effect of blood lead concentrations of 0.5-1?

A

Developmental and growth delay

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10
Q

What is the effect of blood lead concentrations of 1-2?

A

Haemoglobin begins to fall

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11
Q

What is the effect of blood lead concentrations of 2-3?

A

Nerve conduction velocity impeded

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12
Q

What is the effect of blood lead concentrations of 3-4?

A

Overt anaemia

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13
Q

What is the effect of blood lead concentrations of 4-5?

A

Severe CNS toxicity

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14
Q

What is the effect of blood lead concentrations of 5-6?

A

Increasing risk of death

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15
Q

Why is the potential for adverse effects of environmental lead in children higher than in adults?

A
  • Smaller body size leads to greater per unit body weight exposure
  • Young children are orally exploratory, making them more likely to ingest lead-containing dust and soil
  • Physiological update rates of lead are higher in children than adults
  • Potential for adverse developmental effects
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16
Q

What are the pools of lead distribution in the body?

A
  • Blood
  • Skin and muscle
  • Bone and dentine
17
Q

What % of lead distributes into the blood?

A

2%

18
Q

Where is lead mostly found within the blood?

A

Bound to the erythrocyte membrane

19
Q

What % of lead distributes to the skin and muscles?

A

2-3%

20
Q

What % of lead distributes to bone and dentine?

A

95%

21
Q

What is the biological half life of lead distributed to bone and dentine?

A

20-30 years

22
Q

What systems are affected by the toxic effects of lead?

A
  • Haematological
  • Neurological
  • Renal
23
Q

How does lead affect the haematological system?

A

By affecting enzymes essential for the production of haem

24
Q

What enzymes essential for the production of haem are affected by lead?

A
  • 5-aminolaevulinic acid dehydratase (ALAD)

- Ferrochelatase

25
Q

What is the result of leads effect on enzymes essential for the production of haem?

A
  • Anaemia

- Elevated plasma concentrations of 5-aminolaevulinic acid (ALA) and zinc protoporphyrin (ZPP)

26
Q

What are the features of the anaemia caused by lead poisoning?

A
  • Microcytic

- Hypochromic

27
Q

How might lead poisoning manifest neurologically?

A

Cognitive impairment

28
Q

When might lead poisoning manifest with cognitive impairment?

A
  • As a result of chronic low-level lead exposure

- Acute encephalopathy

29
Q

What is the mechanism of neurotoxicity in lead poisoning?

A

Unknown

30
Q

How might lead poisoning affect the kidneys?

A

Acute severe lead exposure may give rise to proximal tubular dysfunction resulting in glycosuria and aminoaciduria

31
Q

What kidney pathology might result from chronic lead exposure?

A

Interstitial nephritis

32
Q

What is the most important initial aspect of the management of lead poisoning?

A

Removal of the child from the source of exposure

33
Q

What is required in order to remove the child from the source of lead exposure?

A

A comprehensive environmental assessment

34
Q

What is used in the treatment of lead poisoning?

A

Chelating agents

35
Q

What is the purpose of chelating agents in lead poisoning?

A

To enhance the elimination of lead

36
Q

How do chelating agents enhance the elimination of lead?

A

They form water-soluble complexes with lead, preventing its binding to cell components

37
Q

What happens to complexes produced with lead by chelating agents?

A

They are excreted in the urine

38
Q

What are the most widely used chelating agents in lead poisoning?

A
  • IV sodium calcium edetate (EDTA)

- Oral succimer (2,3-dimercaptosuccinic acid, DMSA)

TAS Accidents and Poisoning ✅ (12 decks)

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