LEC 9 - TRACE ELEMENTS - aluminum, arsenic, cadmium, chromium, and copper Flashcards
aluminum, arsenic, cadmium, chromium, and copper
trace elements are can be divided into 2 which are
essential and non essential
a trace element that is considered that is needed in the different processes in the body and cause deficiency
essential trace elements
Any element that is not considered essential is classified
as
nonessential
Nonessential trace elements are of
medical interest primarily because many of them are _____.
toxic causing toxicity
METHODS AND INSTRUMENTATION
- 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
Crystalline silver white ductile metal
aluminum
most abundant metal on earth’s crust
aluminum
despite being the abundant metal on earth’s crust, it only constitute _____%
8%
aluminum
it is always found and combined with other elements
oxygen, silicon, and fluorine
Aluminum as the metal is obtained from ____.
aluminum-containing minerals
characteristic of aluminum
Good conductivity of heat & Electricity
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
ease of welding, tensile strength, light weight, and corrosion-resistant oxide coat
is used for beverage cans, pots and pans,
airplanes, siding and roofing, and foil
Aluminum
Aluminum compounds have many different uses, for
example, as __ in water treatment
alums
Aluminum compounds have many different uses, for
example, as ____ in
abrasives and furnace linings
alumina
aluminum is found in consumer products such as
antacids, astringents, buffered aspirin, food additives, cosmetics, and antiperspirants.
how do we able to get in contact or absorb aluminum and introduce it inside the body?
Aluminum absorbs in our body through
ingestion (orally),
inhalation and
parenterally.
can we absorb aluminum through dermal absorption
There is no indication of
dermal absorption
The absorption efficiency is dependent on ____, ____, and ___
chemical form,
particle size (inhalation), and concurrent dietary exposure
to chelators
examples of chelators
citric and lactic acid
are compounds which binds, in order to render readily excretable
chelators
After a relatively quick uptake of aluminum into the
intestinal walls, its passage into the blood is much
slower
Once aluminum are now in ____ , transport
mechanism become slower
blood circulation
In plasma, aluminum is bound to carrier proteins such as
____
transferrin
Aluminum binds to various ligands in the blood and distributes to every organ such as
bone and lung tissues
once the aluminum is distributed in the organs, the highest distribution is found in the
bone (50% of the body burned )
the aluminum is can be distributed in the lungs, how much it can store in lungs
about 25% of the body burden
aluminum levels in lungs increase with age
true or false
true
Urine accounts for ______ of aluminum excretion
95%
Urine accounts for 95% of aluminum excretion with _____
eliminated in the bile
2%
is toxicity caused by aluminum well understood?
naur, the reported cases of aluminum is not that prevalent to study the toxicity of aluminum - rare cases
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
true
administration of aluminum to experimental animals is
known to produce ___ similar to that seen
in Alzheimer disease in man
encephalopathy
aluminum’s toxicity which is characterized by stuttering, gait disturbance, myoclonic jerks, seizures, coma and abnormal EEG
encelophathy
aside from encephalopathy, what are the other conditions we can encounter aluminum toxicity
osteomalacia or aplastic bone disease
proximal myopathy
increased risk of infection
microcytic anemia
increased left ventricular and decreased myocardial function
in aluminum toxicity, it is characterized by (painful
spontaneous fractures, hypercalcemia, and tumorous
calcinosis
osteomalacia and aplastic bone disease
blood feature of a person with toxicity in aluminum
microcytic anemia
Aluminum toxicity occurs in people with ____ who are treated by dialysis with aluminum-contaminated solutions or oral agents that contain aluminum
renal
insufficiencies
The clinical manifestations of aluminum toxicity include
anemia, bone disease, and progressive dementia with increased concentrations of aluminum in the brain, and impaired
neurologic development
Prolonged intravenous feeding of preterm infants with
solutions containing aluminum is associated with ____
impaired neurologic development
Aluminum is primarily measured using ____
ICP-MS or GFAAS
Inductively Coupled Plasma Mass Spectrometry (ICP-MS)
Graphite Furnace Atomic Absorption Spectroscopy (GFAAS)
aluminum
Accurate measurements are often complicated by the increased risk of environmental contamination of specimens
true or false
true
______ levels are useful in determining toxic aluminum exposures, monitoring exposure overtime, and monitoring chelation therapy
Urine and serum
ubiquitous element displaying both metallic and non metallic properties
arsenic
a highly toxic trace element commonly seen in rat poison
arsenic
what type of trace element is arsenic?
non essential
it can’t cause deficiency and has no medical significance and usually seen in earth’s crust, used in rat poison
arsenic
concentration of arsenic in earth’s crust
1.5 - 2 mg/kg
what is the largest source of arsenic exposure 25-50 ug/kg
food
Anthropogenic sources of arsenic
burning of coil, fossil fuels, timber and its use in agriculture
a source of arsenic that release
three times more of arsenic than natural sources
anthropogenic sources
The main current use of arsenic is as a
wood
preservative
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.
duration and extent; inorganic and methylated
symptoms/organs affected For acute arsenic exposure
gastrointestinal
bone marrow
cardiovascular
CNS
renal
liver
an acute arsenic exposure symptoms that are characterized by
nausea, emesis, abdominal pain, and
rice water diarrhea
gastrointestinal
acute exposure to arsenic will cause ____ to bone marrow
pancytopenia
anemia
basophilic stippling
For chronic arsenic exposure, systems and symptoms may
include
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
mees’ lines (nail) are seen in
dermatologic symptoms of chronic arsenic exposure
(“socks and glove” neuropathy
and tremor are seen in
affected CNS of chronic exposure to arsenic
Chronic arsenic exposure has been shown to cause
_______, a severe form of peripheral vascular disease which leads to
gangrenous changes
blackfoot disease
The white powder of arsenic trioxide is __ and ___,
and one of the most common poisons in human history
odorless, tasteless
arsenic’s Doses of ______ g produce toxic symptoms
0.01-0.05
The lethal dose of arsenic is reported to be between ___;
0.12-0.3 g
Immediate treatment of expected exposure consists of ___ and ____ to reduce arsenic
absorption.
lavage and use of activated charcoal
rice water diarrhea is associated to what symptoms of arsenic?
gastrointestinal symptoms of acute exposure to arsenic
treatment for arsenic aside from antidotes that has act as chelators
activated charcoal
the most effective antidote for arsenic poisoning are
dimercaprol
penicillamine
succimer
dimercaprol is also known as
british anti-lewisite
in 2000, US FDA approved the use of ___ for the treatment of acute promyelocytic leukemia
arsenic trioxide
acute promyelocytic leukemia treated with arsenic trioxide is diagnosed in ___ people in US every year
1500 people
The main routes of exposure of ARSENIC are _____
ingestion of arsenic
containing foods, water, and beverages or inhalation of
contaminated air
2 forms of arsenicq
organic and inorganic
a form of arsenic that are commonly found in fish and sea food
organic forms
organic forms of arsenic examples
arsenocholine and arsenobetaine
form of arsenic that are considered non toxic and cleared rapidly after 1-2 days
organic
how do we measure arsenic
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)
arsenic
are intermediate in toxicity and arise
primarily from metabolism of inorganic species, but small
amounts may arise directly from food.
Methylated species
Organic methylated arsenic compounds examples
monomethylarsonic acid (MMA) and dimethylarsenic
acid (DMA
where are monomethylarsonic acid (MMA) and dimethylarsenic
acid (DMA) formed
hepatic metabolism of
As(3+) and As(5+)
The methylated ___ forms are considered less
toxic than As(3+) and As(5+);
inorganic
The methylated inorganic forms are considered less
toxic than As(3+) and As(5+); however, they are
eliminated slowly (______ week)
1-3
Soft, bluish white metal which is easily cut with a knife
CADMIUM
cadmium is commonly found in
batteries
Principal industrial uses of _____ include manufacture
of pigments and batteries, as well as in the metal-plating
and plastics industries
cadmium
_____ constitute the
largest sources of airborne cadmium exposure
the burning of fossil fuels such as coal and oil and the incineration of municipal waste materials
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
zinc, lead, and copper
The absorption of cadmium in cigarette smoke is ____ and smokers of tobacco products have about twice the cadmium abundance in their bodies as nonsmokers
10-50%
For nonsmokers, the primary exposure to cadmium is
through _____
ingested food
Absorption of cadmium is higher in (female, male) than in (female, male)
due to differences in iron stores
higher in females than in males
why is cadmium has higher concentration in female than male?
it has affinity to iron molecules
organ that cadmium mostly accumulates is in
kidney
since cadmium mostly accumulates in kidney, what will it cause then?
proteinuria
About 90% of ingested cadmium is excreted in the _____
due to the low absorbance of cadmium from the gut.
feces
The absorption of inhaled cadmium in air (airborne) is 10%
to 50% with gastrointestinal absorption of cadmium
estimated to be ___%
5
In cadmium, what seems to be the reason of toxicity?
Toxicity is believed to be a result of protein-Cd adducts
causing denaturation of the associated proteins, resulting
in a loss of function
Ingestion of high amounts of cadmium may lead to a (ACUTE ) rapid
onset with severe ____, ____, and ____
nausea, vomiting, and abdominal pain
___ is a common presentation for chronic cadmium exposure, often resulting in slow-onset proteinuria.
Renal dysfunction
Cadmium exposure can affect the liver, bone, immune,
blood, and nervous systems
true or false
true
____ can be used as a chelating agent in cadmium
poisoning
EDTA
Cadmium is usually quantified by __ and /)___
GFAAS and ICPMS;
Graphite Furnace Atomic Absorption Spectroscopy
(GFAAS)
Inductively Coupled Plasma Mass Spectrometry (ICP-MS)
can we use ICP-AES in cadmium as well?
yes , inductively couples plasma atomic emission spectroscopy
Cadmium’s urinary excretion is
Urinary excretion is about 0.001% and 0.01% of the body burden per 24 hours
At low exposure of cadmium, ___sample used.
urine
In blood, cadmium is found mostly ___ in the RBCs
(70%)
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??
okii, pang past exposure lang bawal recent.
Chromium (Cr), from the Greek word chroma which means
colors
an element that makes rubies red and emeralds green
CHROMIUM (Cr)
21st most abundant element in earth’s crust
chromium
used in manufacturing stainless steel
chromium
Occupational exposure to chromium occurs in _____
wood treatment, stainless steel welding, chrome plating, the leather tanning industry, and the use of lead chromate or
strontium chromate paints
Chromium exists in two main valency states
trivalent (3+)
hexavalent (6+)
among the two valency site of chromium, which one is better absorbed and more toxic
chromium -hexavalent - 6+
carrier protein of chromium
transferrin and albumin
Transferrin binds the newly absorbed chromium at ___
site B
______ acts as an acceptor and transporter of
chromium if the transferrin sites are saturated
Albumin
Other plasma proteins, including __, bind chromium
β- (beta) and (gamma) γ globulins
and lipoproteins
what does chromium can do in insulin?
Enhances insulin action
valence site of chromium that is essential dietary element
trivalent as it maintains normal metabolism of glucose, fat, and cholesterol
The estimated safe and adequate daily intake of chromium
for adults is in the range of__ μg/d,
50-200
Chromium deficiency is characterized by
glucose intolerance, glycosuria, hypercholesterolemia, decreased
longevity, decreased sperm counts, and impaired fertility
once in contact with hexavalent chromium, the person can develop what condition?
Severe dermatitis and skin ulcers
cr 6+
_____
reported in printers, cement workers, metal
workers, painters, and leather tanners
Allergic dermatitis with eczema
When inhaled, Cr(6+) is a respiratory tract irritant, resulting in ____
airway irritation, airway obstruction, and
possibly lung cancer
Low-dose, chronic chromium exposure typically results
only in
transient renal effects
Low-dose, chronic chromium exposure typically results
only in transient renal effects causing ___
elevated urinary b2-microglobulin (an indicator
of renal tubular damage levels)
in terms of age, which one accumulates more chromium
younger person
how do we measure chromium
GFAAS, NAA, or ICP-MS
graphite furnace atomic absorption spectroscopy
Neutron activation analysis (NAA)
inductively coupled plasma mass spectrometry
In chromium,
can Plasma, serum, and urine indicate the total body status of the individual,
naur, however urine may be useful for metabolic studies
Relatively soft yet tough metal
copper
Excellent Electrical & heat conducting properties
copper
Copper is an essential trace element found in four
oxidation states
Cu(0), Cu(1+), Cu(2+), and Cu(3+),
most stable form of copper
copper 2+ (Cuprous iron)
Cofactor of several metalloenzymes
copper
Critical for the reduction of iron in Heme synthesis
copper
Copper is distributed through the body with the highest
concentrations found in ______
liver, brain, heart, and kidneys.
Copper is also found in the
cornea, spleen, intestine, and
lung
The average daily intake is approximately ____
of copper for adults.
10 mg or more
explain the direction and the carrier of copper once introduced in the body
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
which carrier protein is responsible in distributing copper throughout the body
ceruloplasmin
In a normal physiological state, 98% of copper
excretion is through the
bile
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
urine and sweat
Copper is a component of the different metalloenzymes in
the body such as:
Ceruloplasmin, cytochrome C oxidase, superoxide
dismutase, tyrosinase, metallothionein, dopamine
hydroxylase, lysyl oxidase, clotting factor V and
unknown enzyme that cross links keratin in hair
can we find copper deficiency in premature infants?
yep
Seen in conditions involving impairment of copper absorption which is seen in severe diffuse diseases of
______
small bowel, lymphosarcoma, & scleroderma
Extreme copper deficiency is called “___”
Menkes Disease
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
Menkes Disease
Menkes Disease life expectancy
3 months to age of 5
Copper is an irritant to
epithelia & mucus membranes and can cause ______.
renal damage and hemolysis
Copper induced emesis has characteristic
blue-green
color - vomiting green
Genetically determined copper accumulation disease
that usually presents between ages of 6 and 40 years
wilson’s disease
treatment for copper toxicity
zinc acetate or chelation therapy
___ levels and the direct
measurement of free copper are key diagnostic steps
in the diagnosis of Wilson’s disease
Serum ceruloplasmin
Neurological disorders, liver dysfunction, and Kayser
Fleischer rings (green-brown discoloration) in the
cornea caused by copper deposition
“Wilson’s Disease”
low copper in serum and urine means
nutritional deficiency
low serum copper but high in urine means
menkes syndrome
significant increase amount of copper in serum and high amount in urine means
acute copper toxicity
copper both high in serum and urine means
chronic copper toxicity
normal copper or low copper in serum and high or significant increase copper in urine means
wilkon’s disease
significant increase or high copper in serum but normal in urine means
smoking, inflammatory conditions
estrogen and pregnancy
