USMLE (Fach) / Pharmacology - Toxicities and side effects (Lektion)

Vorderseite Lead poisoning
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Sources of exposure:- Battery manufacturing, metallurgy, corrosion inhibition- Gun range- Tableware containing lead

Risk factors:- Home built before 1978- Pica or mouthing behaviors (eg, infants, developmental delay)- Sibling with lead poisoning- Low socioeconomic status- Immigrant or international adoptee

Clinical features:- May be asymptomatic- Abdominal pain/constipation- Cognitive impairment/behavioral problems- Encephalopathy- Paralysis of the radial or peroneal nerve (wrist/foot drop)- Symptoms of anemia- Kidneys: Nephropathy, renal cell carcinoma- Purple-bluish line on the gums (lead line or Burton line)

Management:- Obtain a venous sample (if screening performed by capillary sample)- Environmental surveillance (identify & remove lead sources)- Notify public health department- Nutritional counseling- Chelation therapy if lead level ≥ 45 µg/dL (children) or ≥ 50/80 µg/dL (symptomatic/asymptomatic adults)→ Oral succimer with/without IV/IM EDTA

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