Lead Toxicity Flashcards
1
Q
What are some of the effects of lead in the body that made it so bad?
A
- distorts enzymes and proteins
- inhibits calcium entry into cells
- affects heme synthesis
- can interfere with myelin formation or cause brain edema
2
Q
What is the current regulation for acceptable level of lead in children’s blood?
A
<5 mcg/dL
3
Q
Why is lead testing necessary at 1 and 2 yo?
A
- acceptable levels at 1 does not predict acceptable levels at 2 due to increased mobility of child and increased hand to mouth activity
4
Q
Where do we find lead?
A
- environment (pipes)
- occupational exposure
- hobbies (stained glass or casual target shooting)
- folk remedies
- cosmetics
- imported food or toys
5
Q
What two steps of heme biosynthesis are most sensitive to inhibition by lead?
A
- porphobilinogen synthase
- ferrochelatase
6
Q
What should you suspect if there are elevated lead levels in an older child?
A
change in environment or developmental delay
7
Q
What does lead exposure in utero predispose the fetus to?
A
- premature birth, low birth weight, decreased head size, deficits in neuro-cognitive and behavioral function
8
Q
What diagnostic testing should be done to determine lead toxicity?
A
- free erythrocyte protophyrin
- CBC (concurrent iron deficiency?)
- blood lead levels
9
Q
What chelating agents are used for the medical management of high lead levels?
A
- CaEDTA (inpatient)
- BAL (levels over 70 mcg/dL)
- Succimer (outpatient)
