Podcast
Questions and Answers
Which treatment is NOT part of the curative strategy for chronic mercury toxicity?
Which treatment is NOT part of the curative strategy for chronic mercury toxicity?
- Proper intake of Ca, Zn & Fe (correct)
- BAL & its oral analogues DMSA & DMPS
- Na hyposulphite for dermatitis
- D-penicillamine
Which of the following symptoms is specifically related to the central nervous system effects of mercury toxicity?
Which of the following symptoms is specifically related to the central nervous system effects of mercury toxicity?
- Gray line on the gum
- Albuminuria
- Mercurial dysentery
- Kinetic tremors (correct)
What is the primary focus of the prophylactic treatment for individuals exposed to mercury?
What is the primary focus of the prophylactic treatment for individuals exposed to mercury?
- Periodic medical examinations (correct)
- Gastrointestinal detoxification
- Administration of tranquilizers
- Surgical intervention for injuries
Which form of mercury exposure leads to symptoms such as gingivitis and loose teeth?
Which form of mercury exposure leads to symptoms such as gingivitis and loose teeth?
Which substance is specifically mentioned as a reducing agent in the context of mercury antidotes?
Which substance is specifically mentioned as a reducing agent in the context of mercury antidotes?
What condition is characterized by insomnia, hypertension, and pink painful hands due to mercury exposure?
What condition is characterized by insomnia, hypertension, and pink painful hands due to mercury exposure?
Which form of mercury is primarily toxic when inhaled?
Which form of mercury is primarily toxic when inhaled?
What is a major clinical presentation of acute mercury toxicity affecting the gastrointestinal tract?
What is a major clinical presentation of acute mercury toxicity affecting the gastrointestinal tract?
What severe condition can result from acute toxic exposure to mercuric compounds affecting the renal system?
What severe condition can result from acute toxic exposure to mercuric compounds affecting the renal system?
What is a common cause of death in cases of acute mercury toxicity within 10 days?
What is a common cause of death in cases of acute mercury toxicity within 10 days?
Which type of mercury is considered corrosive and nephrotoxic?
Which type of mercury is considered corrosive and nephrotoxic?
What treatment is essential for managing acute mercury toxicity?
What treatment is essential for managing acute mercury toxicity?
Which of the following is NOT a source of mercury exposure?
Which of the following is NOT a source of mercury exposure?
Flashcards
Mercurialism
Mercurialism
A condition caused by chronic exposure to mercury, characterized by a range of symptoms affecting multiple body systems.
Mercurial dysentery
Mercurial dysentery
A key symptom of mercurialism affecting the gastrointestinal tract, characterized by diarrhea, mucus, and blood in the stool.
Gray line on the gum
Gray line on the gum
A classic sign of mercurialism affecting the mouth, characterized by a gray line along the gum margin.
Chelation therapy
Chelation therapy
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Kinetic tremors
Kinetic tremors
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What is mercury?
What is mercury?
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What are the three main forms of mercury?
What are the three main forms of mercury?
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How is elemental mercury toxic?
How is elemental mercury toxic?
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What are the effects of inorganic mercury salts?
What are the effects of inorganic mercury salts?
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How do organic mercury compounds pose a threat?
How do organic mercury compounds pose a threat?
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How does mercury exert its toxicity?
How does mercury exert its toxicity?
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What are the symptoms of acute mercury poisoning?
What are the symptoms of acute mercury poisoning?
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How is acute mercury poisoning treated?
How is acute mercury poisoning treated?
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Study Notes
Mercury Toxicity
- Mercury (Hg), also known as hydrargyrum, is a toxic substance.
- Exposure sources include elemental mercury (vapour, dental amalgam, thermometers, sphygmomanometers) and inorganic salts (calomel, mercurous chloride).
- Elemental mercury is only toxic by inhalation.
- Inorganic salts are poorly absorbed if ingested.
- Chronic mercury poisoning from ingested inorganic salts can cause pink teeth (Acrodynia) in children.
- Symptoms of Acrodynia include: insomnia, hypertension, peeling skin, alopecia, pink and painful hands, and acute renal failure within 24 hours.
- Mercuric chloride is a disinfectant, and mercuric fulminate is used in percussion caps.
- Organic mercurial salts are diuretics and fungicides
- Methyl and ethyl mercury are environmental contaminants accumulating in aquatic food chains.
- Mercury reacts with sulfhydryl (-SH) groups, inhibiting cellular enzymatic processes.
- Elemental mercury vapor and organic mercury compounds are toxic to the central nervous system (CNS), and inorganic mercuric salts are corrosive and nephrotoxic.
Acute Mercury Toxicity
- Clinical Presentation (GIT):
- Metallic taste
- Burning sensation from mouth to stomach
- Nausea and blood-tinged vomiting
- Tenesmus (mercurial dysentery) leading to diarrhea with mucus and blood
- Dehydration and collapse
- Clinical Presentation (Renal):
- Acute toxic glomerulonephritis can result in oliguria and anuria/Renal failure.
- Clinical Presentation (Pulmonary):
- Corrosive bronchitis potentially leading to pulmonary edema
- Clinical Presentation (Nervous system):
- Tremors and increased excitability are possible neurological manifestations, particularly with mercury vapour exposure.
- Causes of Death:
- Dehydration within 24 hours
- Renal failure (RF) within 10 days
Treatment of Acute Mercury Toxicity
- Initial Treatment: Immediate removal from further exposure
- Gastric Lavage: Use local antidotes like egg white, skimmed milk (Forms precipitate Hg albuminate) and sodium formaldehyde sulfoxylate (reducing agent). (Converts HgCl2 to non-soluble HgCl)
Chronic Mercury Toxicity ("Mercurialism")
- Clinical Presentation (GIT):
- Increased salivation (an early sign)
- Gray line on the gum
- Gingivitis (swollen, painful, bleeding gingiva)
- Loose teeth
- Gangrene (cancrum oris)
- Clinical Presentation (GIT):
- Intestinal mercury poisoning leads to mercurial dysentery (diarrhea, mucus, and blood)
- Clinical Presentation (Renal):
- Albuminuria, hematuria, granular and hyaline casts
- Oliguria and renal failure
- Clinical Presentation (CNS):
- Kinetic tremors (cerebellar affection)
- Mercury erethism (shyness, loss of confidence, vague fears, depression)
- Dermatitis (skin)
- Mercurialentis (discoloration of eye lens capsule)
Treatment of Chronic Mercury Toxicity
- Prophylactic Treatment:
- Periodic medical examinations for exposed workers
- Proper exhaust ventilation, dust filters, protective clothing (masks, gloves, boots)
- Adequate intake of calcium (Ca), zinc (Zn), and Iron (Fe)
- Curative Treatment:
- Stop further Mercury exposure
- Physiological antidotes (chelation therapy):
- D-penicillamine
- BAL or its oral analogues (DMSA and DMPS)
- Symptomatic Treatment:
- Mouth hygiene
- Tranquilizers for calming/anxiety
- Sodium hyposulphite for dermatitis
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