Lead Toxicity Flashcards
How is lead toxicity Dx?
Blood test
What is the current level of concern for lead toxicity?
> 5 mcg/dL
WHat is the normal blood lead level?
No normal level
In a 12 month old child, with a lead level of 20, what would be a suspected source of lead?
Potentially home renovations
What age is the highest risk of lead poisoning? Why?
2 year old, mobile and will put almost anything into their mouths
What does an acceptable blood lead level at 1 year of age predict about blood lead level at 2 years?
It predicts nothing! Do a blood lead level test!
What are sources of lead in children?
- Envrionment (paint chips)
- Parental Occupation (bring home lead)
- Hobbies (Glass working, shooting)
- Folk remedies
- Cosmetics
- Imported Foods
- Imported Toys
What is the significance of Free Erythrocyte Protoporphyrin levels?
FEP levels can be an indicator of both lead and iron deficiency
What enzyme does lead poison?
Ferrochelatase
What does lead exposure in an older child suggest?
Developmental delay or a change in environment
What does a moderately high lead level and very high FEP suggest?
Lead poisoning with concurrent iron deficiency
What is reference range FEP?
< 70
What are some sources of lead in immigrants?
- Leaded gasoline in home country
- Lead paint in crappy housing
What can lead exposure in pregnancy cause?
- Inverse relationship b/w lead and birth weight
- Relationship b/w lead exposure and preterm births
- Decreased head size
- Decrements in neuro-cognitive/behavioral ability
Briefly describe physiology of lead in body related to pregnancy
- Lead stored for many years in bone
- Mobilization of bone in pregnancy can release lead into blood
- Only way to know lead burden is do repeated blood tests
- After elevated lead is observed, at least one more test should be performed during pregnancy
