Arsenic Toxicity Symptoms Quiz

Study Notes

Heavy Metal Toxicity

Heavy metal toxicity is a major concern, as metals are not degradable and can form poisonous soluble compounds.
Sources of heavy metal toxicity include mining, industry, agriculture, and occupation.

Lead (Pb) Toxicity

Sources of lead toxicity include:
- Batteries
- Glass, plastics, and ceramics
- Lead-based paints
- Combustion of leaded gasoline
- Metal alloys
Environmental effects of lead include:
- Water pollution
- Air and soil pollution
Forms of lead compounds:
- Inorganic lead
- Organo-lead compounds
Toxicokinetics:
- Inorganic lead: not readily excreted, accumulates in blood, bone, and brain
- Organic lead: volatile, lipid soluble, and readily absorbed through the respiratory and gastrointestinal tracts
GIT effects:
- Moderate exposure: constipation and loss of appetite
- High exposure: lead colic, characterized by abdominal pain, nausea, and vomiting
Oral effects:
- High exposure: gingival lead lines (Burton's lines)
Bone effects:
- Chronic exposure: lead replaces calcium and accumulates in bones
Haematological effects:
- Moderate exposure: "lead anemia"
CNS effects:
- Acute exposure: encephalopathy, neurocognitive deficits, tremors, convulsions, mental retardation, and death
- Chronic exposure: decreased learning, cognition, and IQ, hearing impairment, poor postural balance, and behavioral symptoms
Diagnosis:
- Symptoms: according to age and dose
- Lab tests: blood lead level, aminolevulinic acid in urine, and reduction of active blood ALAD enzyme
Management:
- Supportive care: treatment of seizures, controlling cerebral oedema
- Antidotes: metal chelators (succimer, disodium calcium EDTA, British Anti-lewisite, and dimercaprol)

Arsenic (As) Toxicity

Sources:
- Metal hardening
- Insecticides, rodenticides, and fungicides
- Glass industry
- Pigments industry
- Water and food pollutant
Forms:
- Organic: pentavalent arsenate (As5+)
- Inorganic: trivalent arsenite (As3+), arsine gas (AsH3), and pentavalent arsenate (As5+)
Symptoms of acute toxicity:
- Hematemesis and abdominal pain
- Rice-water diarrhea
- Garlic-like breath
- Thirst and metallic taste
- Contact dermatitis
- Arsine gas exposure: acute hemolytic anemia and striking chills
Symptoms of chronic toxicity:
- Stomach pain and diarrhea
- Numbness in hand and feet
- Partial paralysis and blindness
- Chronic lung disease
- Melanosis and keratosis (palms and feet), and black foot disease
Management:
- Supportive care: exchange transfusion, vigorous hydration, and hemodialysis (if renal failure occurs)
- Antidotes: metal chelators (no benefit in chronic toxicities)

Cadmium (Cd) Toxicity

Sources:
- Silver mining
- Industrial effluent
- Household cleansers
Acute vs. chronic cadmium toxicity:
- Acute: GI effects (oral) and local respiratory irritation (inhalation)
- Chronic:
  - Kidney: most cadmium-sensitive organ (atrophy)
  - Lungs: emphysema
  - CVS: hypertension
  - Bones: osteomalacia (bone softening)
  - Testes: necrosis
  - Itai-Itai disease
Itai-Itai disease:
- Cause: contamination of river water by cadmium from silver mining companies
- Effects: "It hurts-it hurts"

Description

Test your knowledge on the symptoms of acute and chronic arsenic (As) toxicity. From hematemesis and garlic-like breath to numbness in hands and feet, this quiz covers a range of manifestations associated with arsenic poisoning.