TRACE ELEMENTS CCHM Flashcards
Trace Elements Methods and Instrumentation
- Atomic Absorption Spectrometer (AAS)
- Atomic Emission Spectrometer (AES)
- Graphite Furnace Atomic Absorption Spectroscopy (GFAAS)
- Inductively coupled Plasma Atomic Emission Spectroscopy (ICP-AES)
- Inductively couples plasma Mass Spectrometry (ICP-MS)
Crystalline silver white ductile metal
Most abundant metal
Oxygen, silicon & fluorine
Aluminum containing minerals
Good conductivity of heat & Electricity
ALUMINUM
Aluminum
Health effects & toxicity
Toxicity is not well understood
Encephalopathy
Osteomalacia or aplastic bone disease
Proximal myopathy
Increased risk of infection
Microcytic anemia
Increased left ventricular mass & decreased myocardial function
Renal insufficiencies
Anemia
Bone disease
Progressive dementia
Impaired neurologic Development
Aluminum Laboratory
ICP MS
GFAAS
In aluminum, Urine and serum levels are useful in _____, ______ and _____
determining toxic exposures, monitoring exposure overtime, and monitoring chelation therapy
Metallic & non metallic properties
Earth’s crust (1.5 2.0 mg/kg)
Food (25 50 ug/d)
Anthropogenic sources
ARSENIC
Arsenic
Health effects & toxicity
Nausea, emesis, abdominal pain, rice water diarrhea
Pancytopenia, anemia, & basophilic stippling
ECG changes
Encephalopathy & neuropathy
Renal insufficiency & renal failure
Hepatic systems
Mees Lines”, hyperkeratosis, hyperpigmentati on, & alopecia
Cirrhosis & hepatomegaly
Hypertension & PVD
CNS neuropathy & tremor
Squamous cell, hepatocellular, skin, bladder, lung, & renal carcinomas
“Black foot disease”
Arsenic Laboratory
ICP MS
GFAAS
HG AAS
____is desired, a separation method is employed either online or off line prior to metal analysis
Arsenic speciation
Soft, bluish white metal which is easily cut with a knife
Burning of fossil fuels such as coal and oil & incineration of municipal waste materials
CADMIUM
Toxicity is believed to be a result of ____, ____, ____, ____, ____,____
___ can be used as a chelating agent in cadmium poisoning
“Protein Cd” adducts
Severe nausea, vomiting, and abdominal pain
Renal dysfunction
Nasal epithelial damage and lung damage similar to emphysema
EDTA
Laboratory Cadmium
GFAAS & ICP MS
ICP AES
In ____, Urinary excretion is about ___ in the RBC
____ of the body burden per 24 hours.
Cadmium
70%
0.001% and 0.01%
Greek word “___”
Rubies red & emeralds green
21 st most abundant element in the earth’s crust
Stainless steel
chromium
chroma
Chromium Health effects:
Enhances insulin action
Metabolism of glucose, fat, & cholesterol
Adequate daily intake of chromium (50 200ug/d)
Chromium Deficiency
Insulin resistance
Impaired glucose tolerance
Hyperlipidemia
Glucose intolerance, glycosuria, hypercholesterolemia, decreased longevity, decrease in sperm counts, and impaired fertility
Chromium Toxicity
Powerful oxidizing agent
Cr(6+)
In chromium, ___ At physiological pH
CrO42+
Toxicity of Chromium
It similarity to essential phosphate & sulfate anions
Skin ulcer, renal & hepatic necrosis
Severe dermatitis & skin ulcers
Allergic dermatitis with eczema
protein complex in chromium
Cr (3+)
Chromium Toxicity
Airway irritant, airway obstruction, & possibly lung cancer
Lung, kidneys, liver, skin, & immune system
Transient renal effects
Elevated urinary B 2 Microglobulin (an indicator of renal tubular damage)
Chromium Laboratory
GFAAS
NAA
ICP MS
In chromium, ___, ___, and ___ do not indicate the total body status of the individual, whereas ___may be useful for metabolic studies
Plasma, serum, and urine
urine levels
Relatively soft yet tough metal
Electrical & heat conducting
Forms___,____ and ______
Cu(0), Cu(1+), Cu(2+), Cu(3+)
Cofactor of several metalloenzymes
Heme synthesis
Cellular respiration
Collagen synthesis
Copper
alloys w/ zinc, tin, & nickel
Copper Health effects:
Ceruloplasmin, cytochrome C oxidase, superoxide dismutase, tyrosinase, metallothionein, dopamine hydroxylase, lysyl oxidase, clotting factor V and unknown enzyme that cross links keratin in hair
Copper Deficiency
Premature infants
Severe diffuse diseases of small bowel, lymphosarcoma, & scleroderma
Malnutrition, malabsorption, chronic diarrhea, hyperalimentation, & prolonged feeding with low copper, total milk diets
Neutropenia & hypochromic anemia in early stages
Osteoporosis & various bone and joint abnormalities
Decreased pigmentation of the skin and general pallor
Hypotonia, apnea, and psychomotor
Retardation
Coronary heart disease
“Menkes Disease”
This invariably fatal, progressive brain, disease characterized by peculiar hair, called kinky or steely, and retardation of growth.
“Menkes Disease”
Progressive mental deterioration, coarse feces, disturbance of muscle tone, seizures, and episodes of severe hypothermia.
“Menkes Disease”
Interferes with absorption of ____ and ___
is an irritant to epithelia & mucus membranes.
Hepatic & renal damage with hemolysis.
induced ___ has characteristic “blue green color”
“Wilson’s Disease”
Genetically determined disease that usually presents between ages of ___ and ___ years old
Neurological disorders, liver dysfunction, and Kayser Fleischer rings in the cornea
Copper
Iron and zinc
emesis
6 - 40 y/o
Copper lab
Flame aas , icp ms , icp aes , and asv
Serum copper & urine copper
Direct measurement of free copper & Serum ceruloplasmin
4th most abundant element
Most abundant transition metal
Classified as a trace element
Oxygen transport
Participates in ___
Agent in ___ and ____
Iron
redox chemistry
Agent in redox & electron transfer reactions
Increased in serum Iron:
a.Condition of increased erythrocyte destruction ( haemolytic anemia)
b. Decreased blood formation (lead poisoning, pyridoxine deficiency)
c. Increased release of iron from the body of stores (release of ferritin in acute hepatic cell necrosis)
d. Defective iron storage (pernicious anemia)
e. Increased rate of absorption (hemochromatosis and transfusion siderosis)
Decreased in serum Iron:
. Generalized iron deficiency (lack of sufficient dietary iron)
b. Inadequate absorption of iron
c. Chronic loss of iron as a result of bleeding or nephrosis
d. Impared releases of iron from the reticuoendothelial system (infection)
e. Malignant
f. Rheumatoid arthritis
Increase in TIBC:
a. Iron defificency
b. Late pregnancy
c. Oral contraceptives
d. Viral Hepatitis
Decreased in TIBC:
Chronic infections
b. Malignancy
c. Iron poisoning
d. Nephrosis
e. Kwashiorkor
f. Thalassemia
___ bound to transferrin
Serum or heparinized plasma
Oxalate citrate and EDTA
Early morning sampling
Specimen with visible hemolysis should be avoided
“TOTAL IRON CONTENT”
Fe(3+)
amount of iron that could be bound if transferrin and other minor iron binding proteins present in the serum or plasma sample weresaturate
TIBC
called transferrin saturation, is the ratio of serum iron to TIBC.
Approximately 20% to 50%, but it varies with age and sex.
“PERCENT SATURATION”
Measured by immunochemical methods such as ___.
Iron deficiency
Chronic infections & malignancy
Iron overload & hemochromatosis
TRANSFERIN
nephelometry
Immunochemical methods
Iron deficiency anemia
Iron overload & hemochromatosis
Chronic infections, malignancy, and viral hepatitis
FERRITIN
Fe Laboratory
AAS
ICP-ms
Iron quantification in liver is not used for the evaluation of ____
____ testing has not yet been shown to be clinically useful.
Iron
acute iron toxicity
hepcidin
Soft, bluish white, highly malleable and ductile
Poor conductor of electricity & heat and resistant to corrosion
Lead
> 45 μg/dL ___
60 μg/g ___
IQ declines are seen in children with blood lead levels of 10 μg/dL or more
Clumsiness, gait abnormalities, headache, behavioral changes, seizures, &severe cognitive and behavioral problems.
Abdominal pain, constipation, and colic.
Lead
treshold for acute clinical intervention
upper treshold
Lead Laboratory
ICP-MS
ICP-AES & GFAAS
The most common specimen type is____ the result of which is commonly referred to as the ____
Elevated lead levels in capillary blood specimens should be confirmed with a venous specimen
lead
whole venous blood,
blood lead level
“Quicksilver”
Heavy, silvery metal
Liquid at room temp. & pressure
Hg(0), Hg(1+), and Hg(2+).
Organic mercury
Mercury
Mercury Health effects & Toxicityy
autism in children
Headache, tremor, impaired coordination, abdominalcramps, diarrhea, dermatitis, polyneuropathy, proteinuria, and hepatic dysfunction
Mercury Laboratory
ICP-MS
Cold vapor AAS
Mercury is usually determined as total mercury levels in ____ and ___ without regard to chemical form.
blood
urine
12thmost abundant element
Found in over 250 minerals
Constituent of metalloenzymes and as an enzyme activator
MANGANESE
Health effects of Manganese
Arginase, pyruvate carboxylase, and manganese superoxide dismutase.
Hydrolases, kinases, decarboxylases, and transferases
Many of these activations are not specific to manganese and other metal ions (magnesium, iron, or copper)
Manganese Deficiency
Blood clotting defects, hypocholesterolemia, dermatitis, and elevated serum calcium, phosphorus, and alkaline phosphatase activity
Epilepsy, hip abnormalities, joint disease, congenital malformation, heart and bone problems, and stunted growth in children
Toxicity of Manganese
Nausea, vomiting, headache, disorientation, memory loss, anxiety, and compulsive laughing or crying.
Resembles Parkinson’s diseasewith akinesia, rigidity, tremors,mask-like faces.
locuramanganica(manganese madness)
Manganese lab
ICP-MS
GFAAS
___ is used in conjunction with___ to evaluate possible toxicity or deficiency
Urine manganese
serum manganese
Hard, silvery white metal
Molybdenite, wulfenite, & powellite
MOLYBDENUM
Health effectS of Molybdenum
Xanthine oxidase, aldehyde oxidase, and sulfite oxidase
“Molybdopterin”
Dietary molybdenum deficiency is rare
Molybdenum cofactor deficiency is a recessively inherited error of metabolism
Elevated uric acid in blood and an increased incidence of gout
Laboratory of Manganese
ICP-Ms
GFAAS
Blood levels are less than 60 μg/L
Naturally occurring metalloid
Similar to sulfur (chemical & physical)
Essential trace elements
Major constituent of 40 minerals & minor constituent of 37 others
Selenium
Selenium Health effectS
Glutathione peroxidase (in the form of selenocysteine)
Deiodinaseenzymes and thioredoxin reductase
Selenium Deficiency
Cardiomyopathy, skeletal muscle weakness, and osteoarthritis
Selenium intakes and the rate of cancer of the large intestine, rectum, prostate, breast, ovary, and lungs and leukemia.
“Keshan disease”
“Kashin-beck disease”
an endemic osteoarthritis that occurs during adolescent and preadolescent years.
“Kashin-beck disease”
an endemic cardiomyopathy that affects mostly children and women in childbearing age dizziness, malaise, loss of appetite, nausea, chills, abnormal electrocardiograms, cardiogenic shock, cardiac enlargements, and congestive heart failure
“Keshan disease”
Selenium toxicity
Nausea, vomiting, and diarrhea
Tachycardia
Nails and skin and hair loss, as well as neurologic problems such as unsteady gait or paralysis
Selenium lab
ICP-MS
GFAAS
Determination of urinary and blood selenium is an useful measure of selenium status.
Bluish-white lustrous metal.
Stable in dry air and becomes cover with a white coating when exposed to moisture.
Alloys, especially brass (with copper), in galvanizing steel, in die casting, in paints, in skin lotion.
Treatment for____
Zinc
wilsons disease
zinc deficiency
Growth retardation, slows skeletal maturation, causes testicular atrophy, and reduces taste perception.
Old age, pregnancy, lactation, and alcoholism
“acrodermatitis enteropathica”
adolescent
Health effects of zinc
Oxidoreductases, transferases, hydrolases, leases, isomerases, and lipases.
Synthesis and metabolism of DNA & RNA
Synthesis and metabolism of proteins
Metabolism of glucose and cholesterol, membrane structure maintenance, insulin function, and growth factor affects
First develop a characteristic facial and diaper rash Growth retardation, diarrhea, impaired T-cell immunity, insufficient wound healing, infections, delayed testicular development in adolescence, and early death
“acrodermatitis enteropathica”
Slow growth or weight loss, altered taste, delayed puberty, dwarfism, impaired dark adaptation, alopecia, emotional instability and tremors.
“adolescent”
zinc toxicity
Gastrointestinal symptoms
Decrease in heme synthesis
Hyperglycemia
“zinc fume fever”
Chemically induced pneumonia, severe pulmonary inflammation, fever, hyperpnea, coughing, pains in legs and chest, and vomiting
“zinc fume fever”
zinc Laboratory
FAAS, ICP-AES, ICP-MS
____ in the presence of low ____ usually confirm zinc deficiency.
Serum zinc cannot be interpreted as evidence of ____
Zinc concentration in RBCs is approximately ___ that in serum.
___ should be monitored in patients undergoing long-term zinc therapy
Low urine zinc levels
serum zinc levels
normal zinc stores
10x
Copper status
strong yet lightweight metal commonly found in ____
aluminum Al 13
soda cans
highly toxic element commonly used in ___
Arsenic As 33
rat poison
can be found in some paint pigments
Cadmium ca 48
red-colored metal that is good conductor of electricity
Copper Cu 29
Cars from the 1950s and 60s were often decked out with this
Chromium Cr 24
Rusts by itself which is why a lot of element are added to it to make ___
Iron Fe 26
steel
poisonous, people used to drink from it in medieval times
Lead Pb 82
can lead to ___, a toxic state causing hallucinations and violence
Manganese Mn 25
manganism
deadly liquid element that causes damage to NS.
Mercury Hg 80
tough metal used in many types of power tools
Molybdenum Mo 42
when consumed by cows, can cause them to go into blind staggers
Selenium Se 34
corrodes quickly, added to steel to increase longevity
Zinc Zn 30
