Metabolic/Toxic Disorders

Question 1

Lead poisoning in children

Answer 1

IQ deficits and behavioral impairment. Acute lead encephalopathy from eating paint.

Question 2

Lead poisoning in adults

Answer 2

Abdominal pain, constipation, wrist drop, encephalopathy

Question 3

Burton’s Line

Answer 3

Key sign of lead poisoning, discoloration of the upper gum margin.

Question 4

Mercury poisoning

Answer 4

encephalopathy, sensorimotor neuropathy, tremor. “Mad hatter”

Question 5

Arsenic poisoning

Answer 5

Encephalopathy, painful neuropathy, n/v, diarrhea, arrhythmias. Test in urine.

Question 6

Test for Ar poisoning?

Answer 6

Urine better than blood.

Question 7

Thallium poisoning

Answer 7

In rat poison. Vomiting, diarrhea, paresthesias, late hair los.

Question 8

Manganese poisoning

Answer 8

Looks a lot like PD, but with hyperreflexia.

Question 9

Marasmus

Answer 9

Balanced starvation (deficient in all nutrients)

Question 10

Kwashiorkor

Answer 10

Low protein but carbs for calories.

Question 11

Pickwickian Syndrome

Answer 11

Obstructive sleep apnea

Question 12

Neurological complications of DM

Answer 12

Dementia, increased risk of stroke

Question 13

Vitamin A intoxication

Answer 13

Increased ICP

Question 14

Rum fits

Answer 14

Shakes after alcohol withdrawal (also known as delirium tremens)

Question 15

Central pontine myelinolysis

Answer 15

Overvigorous correction of hyponatremia, get severe paralysis, dysphagia, dysarthria

Question 16

Marchiafava-Bignami Disease

Answer 16

Demyelination of corpus callosum. Seen in chronic alcoholism, rapid psychosis stupor and coma.

Question 17

Alcoholic cerebellar degeneration

Answer 17

Truncal ataxia, superior cerebellar vermis atrophies resulting in loss of purkinje cells

Question 18

Asterixis

Answer 18

Jerking movement when hands extended, from hepatic encephalopathy.

Question 19

Alcoholism-induced subdural hematoma

Answer 19

Shrinking brain, so bridging veins stretch.

Question 20

IMPORTANT: Wernicke’s Encephalopathy

Answer 20

Triad of Ataxia, opthalmoplegia (cant move eyes, esp. lateral rectus), confusion. Due to poor intake of thiamine. Usually with nystagmus.

Question 21

Untreated Wernicke’s encephalopathy leads to?

Answer 21

Korsakoff’s psychosis: anterograde amnesia, confabulation, apathy.

Question 22

B6 (Pyridoxine) deficiency

Answer 22

Neuropathic, pellagrous, anemic. Usually seen in infancy, causes intractable seizures within hours of birth. Death if treated.

Question 23

Cobalamine deficiency

Answer 23

Lack of IF causes pernicious anemia. can cause subacute combined degeneration of posteriolateral spinal cord. Can cause paresthesias in hands/feet, loss of vibration and position sense. Positive romberg.

Question 24

Nitrous Oxide

Answer 24

Can cause degeneration of posteriolateral spinal cord