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CCHM 2 > LEC 9 - TRACE ELEMENTS - aluminum, arsenic, cadmium, chromium, and copper > Flashcards

LEC 9 - TRACE ELEMENTS - aluminum, arsenic, cadmium, chromium, and copper Flashcards

aluminum, arsenic, cadmium, chromium, and copper

1
Q

trace elements are can be divided into 2 which are

A

essential and non essential

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2
Q

a trace element that is considered that is needed in the different processes in the body and cause deficiency

A

essential trace elements

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3
Q

Any element that is not considered essential is classified
as

A

nonessential

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4
Q

Nonessential trace elements are of
medical interest primarily because many of them are _____.

A

toxic causing toxicity

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5
Q

METHODS AND INSTRUMENTATION

A
  • Atomic Absorption Spectrometer (AAS)
  • Atomic Emission Spectrometer (AES)
  • Flame Atomic Absorption Spectroscopy (FAAS)
  • Graphite Furnace Atomic Absorption Spectroscopy
    (GFAAS)
  • Inductively Coupled Plasma Atomic Emission
  • Spectroscopy (ICP-AES)
  • Inductively Coupled Plasma Mass Spectrometry (ICP-MS
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6
Q

Crystalline silver white ductile metal

A

aluminum

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7
Q

most abundant metal on earth’s crust

A

aluminum

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8
Q

despite being the abundant metal on earth’s crust, it only constitute _____%

A

8%

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9
Q

aluminum

it is always found and combined with other elements

A

oxygen, silicon, and fluorine

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10
Q

Aluminum as the metal is obtained from ____.

A

aluminum-containing minerals

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11
Q

characteristic of aluminum

A

Good conductivity of heat & Electricity

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12
Q

since aluminum has the characteristics of Good conductivity of heat & Electricity

it has been used in a wide variety of industrial and household uses

what are the uses and characteristic of aluminum in industrial and household purposes

A

ease of welding, tensile strength, light weight, and corrosion-resistant oxide coat

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13
Q

is used for beverage cans, pots and pans,
airplanes, siding and roofing, and foil

A

Aluminum

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14
Q

Aluminum compounds have many different uses, for
example, as __ in water treatment

A

alums

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15
Q

Aluminum compounds have many different uses, for
example, as ____ in
abrasives and furnace linings

A

alumina

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16
Q

aluminum is found in consumer products such as

A

antacids, astringents, buffered aspirin, food additives, cosmetics, and antiperspirants.

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17
Q

how do we able to get in contact or absorb aluminum and introduce it inside the body?

A

Aluminum absorbs in our body through

ingestion (orally),
inhalation and
parenterally.

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18
Q

can we absorb aluminum through dermal absorption

A

There is no indication of
dermal absorption

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19
Q

The absorption efficiency is dependent on ____, ____, and ___

A

chemical form,
particle size (inhalation), and concurrent dietary exposure
to chelators

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20
Q

examples of chelators

A

citric and lactic acid

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21
Q

are compounds which binds, in order to render readily excretable

A

chelators

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22
Q

After a relatively quick uptake of aluminum into the
intestinal walls, its passage into the blood is much

A

slower

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23
Q

Once aluminum are now in ____ , transport
mechanism become slower

A

blood circulation

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24
Q

In plasma, aluminum is bound to carrier proteins such as
____

A

transferrin

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25
Q

Aluminum binds to various ligands in the blood and distributes to every organ such as

A

bone and lung tissues

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26
Q

once the aluminum is distributed in the organs, the highest distribution is found in the

A

bone (50% of the body burned )

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27
Q

the aluminum is can be distributed in the lungs, how much it can store in lungs

A

about 25% of the body burden

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28
Q

aluminum levels in lungs increase with age

true or false

A

true

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29
Q

Urine accounts for ______ of aluminum excretion

A

95%

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30
Q

Urine accounts for 95% of aluminum excretion with _____
eliminated in the bile

A

2%

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31
Q

is toxicity caused by aluminum well understood?

A

naur, the reported cases of aluminum is not that prevalent to study the toxicity of aluminum - rare cases

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32
Q

although aluminum’s toxicity is not well understood because of low cases, aluminum has been shown to interfere with a variety of enzymatic processes

true or false

A

true

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33
Q

administration of aluminum to experimental animals is
known to produce ___ similar to that seen
in Alzheimer disease in man

A

encephalopathy

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34
Q

aluminum’s toxicity which is characterized by stuttering, gait disturbance, myoclonic jerks, seizures, coma and abnormal EEG

A

encelophathy

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35
Q

aside from encephalopathy, what are the other conditions we can encounter aluminum toxicity

A

osteomalacia or aplastic bone disease
proximal myopathy
increased risk of infection
microcytic anemia
increased left ventricular and decreased myocardial function

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36
Q

in aluminum toxicity, it is characterized by (painful
spontaneous fractures, hypercalcemia, and tumorous
calcinosis

A

osteomalacia and aplastic bone disease

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37
Q

blood feature of a person with toxicity in aluminum

A

microcytic anemia

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38
Q

Aluminum toxicity occurs in people with ____ who are treated by dialysis with aluminum-contaminated solutions or oral agents that contain aluminum

A

renal
insufficiencies

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39
Q

The clinical manifestations of aluminum toxicity include

A

anemia, bone disease, and progressive dementia with increased concentrations of aluminum in the brain, and impaired
neurologic development

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40
Q

Prolonged intravenous feeding of preterm infants with
solutions containing aluminum is associated with ____

A

impaired neurologic development

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41
Q

Aluminum is primarily measured using ____

A

ICP-MS or GFAAS

Inductively Coupled Plasma Mass Spectrometry (ICP-MS)
Graphite Furnace Atomic Absorption Spectroscopy (GFAAS)

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42
Q

aluminum

Accurate measurements are often complicated by the increased risk of environmental contamination of specimens

true or false

A

true

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43
Q

______ levels are useful in determining toxic aluminum exposures, monitoring exposure overtime, and monitoring chelation therapy

A

Urine and serum

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44
Q

ubiquitous element displaying both metallic and non metallic properties

A

arsenic

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45
Q

a highly toxic trace element commonly seen in rat poison

A

arsenic

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46
Q

what type of trace element is arsenic?

A

non essential

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47
Q

it can’t cause deficiency and has no medical significance and usually seen in earth’s crust, used in rat poison

A

arsenic

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48
Q

concentration of arsenic in earth’s crust

A

1.5 - 2 mg/kg

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49
Q

what is the largest source of arsenic exposure 25-50 ug/kg

A

food

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50
Q

Anthropogenic sources of arsenic

A

burning of coil, fossil fuels, timber and its use in agriculture

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51
Q

a source of arsenic that release
three times more of arsenic than natural sources

A

anthropogenic sources

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52
Q

The main current use of arsenic is as a

A

wood
preservative

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53
Q

The relation of clinical signs and symptoms to arsenic exposure depends on the ____ of the exposure to ____ species of arsenic,
as well as the underlying clinical status of the patient.

A

duration and extent; inorganic and methylated

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54
Q

symptoms/organs affected For acute arsenic exposure

A

gastrointestinal
bone marrow
cardiovascular
CNS
renal
liver

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55
Q

an acute arsenic exposure symptoms that are characterized by

nausea, emesis, abdominal pain, and
rice water diarrhea

A

gastrointestinal

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56
Q

acute exposure to arsenic will cause ____ to bone marrow

A

pancytopenia
anemia
basophilic stippling

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57
Q

For chronic arsenic exposure, systems and symptoms may
include

A

o dermatologic (Mees’ lines (nail), hyperkeratosis, hyperpigmentation, and alopecia),
o hepatic (cirrhosis and hepatomegaly),
o cardiovascular (hypertension and peripheral vascular disease [PVD]),
o central nervous system (“socks and glove” neuropathy and tremor),
o malignancies (squamous cell, hepatocellular, skin, bladder, lung, liver and renal carcinomas

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58
Q

mees’ lines (nail) are seen in

A

dermatologic symptoms of chronic arsenic exposure

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59
Q

(“socks and glove” neuropathy
and tremor are seen in

A

affected CNS of chronic exposure to arsenic

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60
Q

Chronic arsenic exposure has been shown to cause
_______, a severe form of peripheral vascular disease which leads to
gangrenous changes

A

blackfoot disease

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61
Q

The white powder of arsenic trioxide is __ and ___,
and one of the most common poisons in human history

A

odorless, tasteless

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62
Q

arsenic’s Doses of ______ g produce toxic symptoms

A

0.01-0.05

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63
Q

The lethal dose of arsenic is reported to be between ___;

A

0.12-0.3 g

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64
Q

Immediate treatment of expected exposure consists of ___ and ____ to reduce arsenic
absorption.

A

lavage and use of activated charcoal

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65
Q

rice water diarrhea is associated to what symptoms of arsenic?

A

gastrointestinal symptoms of acute exposure to arsenic

66
Q

treatment for arsenic aside from antidotes that has act as chelators

A

activated charcoal

67
Q

the most effective antidote for arsenic poisoning are

A

dimercaprol
penicillamine
succimer

68
Q

dimercaprol is also known as

A

british anti-lewisite

69
Q

in 2000, US FDA approved the use of ___ for the treatment of acute promyelocytic leukemia

A

arsenic trioxide

70
Q

acute promyelocytic leukemia treated with arsenic trioxide is diagnosed in ___ people in US every year

A

1500 people

71
Q

The main routes of exposure of ARSENIC are _____

A

ingestion of arsenic
containing foods, water, and beverages or inhalation of
contaminated air

72
Q

2 forms of arsenicq

A

organic and inorganic

73
Q

a form of arsenic that are commonly found in fish and sea food

A

organic forms

74
Q

organic forms of arsenic examples

A

arsenocholine and arsenobetaine

75
Q

form of arsenic that are considered non toxic and cleared rapidly after 1-2 days

A

organic

76
Q

how do we measure arsenic

A

ICP MS, GFAAS or HG AAS

Graphite Furnace Atomic Absorption Spectroscopy
(GFAAS)
Inductively Coupled Plasma Mass Spectrometry (ICP-MS)
Hydride Generation Atomic Absorption Spectrometer (HG AAS)

77
Q

arsenic

are intermediate in toxicity and arise
primarily from metabolism of inorganic species, but small
amounts may arise directly from food.

A

Methylated species

78
Q

Organic methylated arsenic compounds examples

A

monomethylarsonic acid (MMA) and dimethylarsenic
acid (DMA

79
Q

where are monomethylarsonic acid (MMA) and dimethylarsenic
acid (DMA) formed

A

hepatic metabolism of
As(3+) and As(5+)

80
Q

The methylated ___ forms are considered less
toxic than As(3+) and As(5+);

A

inorganic

81
Q

The methylated inorganic forms are considered less
toxic than As(3+) and As(5+); however, they are
eliminated slowly (______ week)

A

1-3

82
Q

Soft, bluish white metal which is easily cut with a knife

A

CADMIUM

83
Q

cadmium is commonly found in

A

batteries

84
Q

Principal industrial uses of _____ include manufacture
of pigments and batteries, as well as in the metal-plating
and plastics industries

A

cadmium

85
Q

_____ constitute the
largest sources of airborne cadmium exposure

A

the burning of fossil fuels such as coal and oil and the incineration of municipal waste materials

86
Q

the burning of fossil fuels such as coal and oil and the
incineration of municipal waste materials constitute the
largest sources of airborne cadmium exposure, along with
______ smelters in some locations

A

zinc, lead, and copper

87
Q

The absorption of cadmium in cigarette smoke is ____ and smokers of tobacco products have about twice the cadmium abundance in their bodies as nonsmokers

A

10-50%

88
Q

For nonsmokers, the primary exposure to cadmium is
through _____

A

ingested food

89
Q

Absorption of cadmium is higher in (female, male) than in (female, male)
due to differences in iron stores

A

higher in females than in males

90
Q

why is cadmium has higher concentration in female than male?

A

it has affinity to iron molecules

91
Q

organ that cadmium mostly accumulates is in

A

kidney

92
Q

since cadmium mostly accumulates in kidney, what will it cause then?

A

proteinuria

93
Q

About 90% of ingested cadmium is excreted in the _____
due to the low absorbance of cadmium from the gut.

A

feces

94
Q

The absorption of inhaled cadmium in air (airborne) is 10%
to 50% with gastrointestinal absorption of cadmium
estimated to be ___%

A

5

95
Q

In cadmium, what seems to be the reason of toxicity?

A

Toxicity is believed to be a result of protein-Cd adducts
causing denaturation of the associated proteins, resulting
in a loss of function

96
Q

Ingestion of high amounts of cadmium may lead to a (ACUTE ) rapid
onset with severe ____, ____, and ____

A

nausea, vomiting, and abdominal pain

97
Q

___ is a common presentation for chronic cadmium exposure, often resulting in slow-onset proteinuria.

A

Renal dysfunction

98
Q

Cadmium exposure can affect the liver, bone, immune,
blood, and nervous systems

true or false

A

true

99
Q

____ can be used as a chelating agent in cadmium
poisoning

A

EDTA

100
Q

Cadmium is usually quantified by __ and /)___

A

GFAAS and ICPMS;

Graphite Furnace Atomic Absorption Spectroscopy
(GFAAS)

Inductively Coupled Plasma Mass Spectrometry (ICP-MS)

101
Q

can we use ICP-AES in cadmium as well?

A

yes , inductively couples plasma atomic emission spectroscopy

102
Q

Cadmium’s urinary excretion is

A

Urinary excretion is about 0.001% and 0.01% of the body burden per 24 hours

103
Q

At low exposure of cadmium, ___sample used.

A

urine

104
Q

In blood, cadmium is found mostly ___ in the RBCs

A

(70%)

105
Q

Cadmium in blood reflects the average uptake during the past few months and can be used for monitoring purposes but does not accurately reflect a recent exposure

oki??

A

okii, pang past exposure lang bawal recent.

106
Q

Chromium (Cr), from the Greek word chroma which means

A

colors

107
Q

an element that makes rubies red and emeralds green

A

CHROMIUM (Cr)

108
Q

21st most abundant element in earth’s crust

A

chromium

109
Q

used in manufacturing stainless steel

A

chromium

110
Q

Occupational exposure to chromium occurs in _____

A

wood treatment, stainless steel welding, chrome plating, the leather tanning industry, and the use of lead chromate or
strontium chromate paints

111
Q

Chromium exists in two main valency states

A

trivalent (3+)
hexavalent (6+)

112
Q

among the two valency site of chromium, which one is better absorbed and more toxic

A

chromium -hexavalent - 6+

113
Q

carrier protein of chromium

A

transferrin and albumin

114
Q

Transferrin binds the newly absorbed chromium at ___

A

site B

115
Q

______ acts as an acceptor and transporter of
chromium if the transferrin sites are saturated

A

Albumin

116
Q

Other plasma proteins, including __, bind chromium

A

β- (beta) and (gamma) γ globulins
and lipoproteins

117
Q

what does chromium can do in insulin?

A

Enhances insulin action

118
Q

valence site of chromium that is essential dietary element

A

trivalent as it maintains normal metabolism of glucose, fat, and cholesterol

119
Q

The estimated safe and adequate daily intake of chromium
for adults is in the range of__ μg/d,

A

50-200

120
Q

Chromium deficiency is characterized by

A

glucose intolerance, glycosuria, hypercholesterolemia, decreased
longevity, decreased sperm counts, and impaired fertility

121
Q

once in contact with hexavalent chromium, the person can develop what condition?

A

Severe dermatitis and skin ulcers

122
Q

cr 6+

_____
reported in printers, cement workers, metal
workers, painters, and leather tanners

A

Allergic dermatitis with eczema

123
Q

When inhaled, Cr(6+) is a respiratory tract irritant, resulting in ____

A

airway irritation, airway obstruction, and
possibly lung cancer

124
Q

Low-dose, chronic chromium exposure typically results
only in

A

transient renal effects

125
Q

Low-dose, chronic chromium exposure typically results
only in transient renal effects causing ___

A

elevated urinary b2-microglobulin (an indicator
of renal tubular damage levels)

126
Q

in terms of age, which one accumulates more chromium

A

younger person

127
Q

how do we measure chromium

A

GFAAS, NAA, or ICP-MS

graphite furnace atomic absorption spectroscopy

Neutron activation analysis (NAA)

inductively coupled plasma mass spectrometry

128
Q

In chromium,

can Plasma, serum, and urine indicate the total body status of the individual,

A

naur, however urine may be useful for metabolic studies

129
Q

Relatively soft yet tough metal

A

copper

130
Q

Excellent Electrical & heat conducting properties

A

copper

131
Q

Copper is an essential trace element found in four
oxidation states

A

Cu(0), Cu(1+), Cu(2+), and Cu(3+),

132
Q

most stable form of copper

A

copper 2+ (Cuprous iron)

133
Q

Cofactor of several metalloenzymes

A

copper

134
Q

Critical for the reduction of iron in Heme synthesis

A

copper

135
Q

Copper is distributed through the body with the highest
concentrations found in ______

A

liver, brain, heart, and kidneys.

136
Q

Copper is also found in the

A

cornea, spleen, intestine, and
lung

137
Q

The average daily intake is approximately ____
of copper for adults.

A

10 mg or more

138
Q

explain the direction and the carrier of copper once introduced in the body

A

transported to liver through albumin or transcuprein, low-molecular-weight components in the portal system

in the liver, copper is incorporated by ceruloplasmin to be distributed in the body

139
Q

which carrier protein is responsible in distributing copper throughout the body

A

ceruloplasmin

140
Q

In a normal physiological state, 98% of copper
excretion is through the

A

bile

141
Q

In a normal physiological state, 98% of copper
excretion is through the bile, with copper losses in the ____ and ___ comprising approximately 2% of
dietary intake

A

urine and sweat

142
Q

Copper is a component of the different metalloenzymes in
the body such as:

A

Ceruloplasmin, cytochrome C oxidase, superoxide
dismutase, tyrosinase, metallothionein, dopamine
hydroxylase, lysyl oxidase, clotting factor V and
unknown enzyme that cross links keratin in hair

143
Q

can we find copper deficiency in premature infants?

A

yep

144
Q

Seen in conditions involving impairment of copper absorption which is seen in severe diffuse diseases of
______

A

small bowel, lymphosarcoma, & scleroderma

145
Q

Extreme copper deficiency is called “___”

A

Menkes Disease

146
Q

This invariably fatal, progressive brain, disease
characterized by peculiar hair, also known as the kinky
hair syndrome due to the presence of kinky or steely
hair, and retardation of growth

A

Menkes Disease

147
Q

Menkes Disease life expectancy

A

3 months to age of 5

148
Q

Copper is an irritant to
epithelia & mucus membranes and can cause ______.

A

renal damage and hemolysis

149
Q

Copper induced emesis has characteristic

A

blue-green
color - vomiting green

150
Q

Genetically determined copper accumulation disease
that usually presents between ages of 6 and 40 years

A

wilson’s disease

151
Q

treatment for copper toxicity

A

zinc acetate or chelation therapy

152
Q

___ levels and the direct
measurement of free copper are key diagnostic steps
in the diagnosis of Wilson’s disease

A

Serum ceruloplasmin

153
Q

Neurological disorders, liver dysfunction, and Kayser
Fleischer rings (green-brown discoloration) in the
cornea caused by copper deposition

A

“Wilson’s Disease”

154
Q

low copper in serum and urine means

A

nutritional deficiency

155
Q

low serum copper but high in urine means

A

menkes syndrome

156
Q

significant increase amount of copper in serum and high amount in urine means

A

acute copper toxicity

157
Q

copper both high in serum and urine means

A

chronic copper toxicity

158
Q

normal copper or low copper in serum and high or significant increase copper in urine means

A

wilkon’s disease

159
Q

significant increase or high copper in serum but normal in urine means

A

smoking, inflammatory conditions
estrogen and pregnancy

160
Q
A

CCHM 2 (22 decks)

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