Question 1

The occurrence of cell membrane damage causing normal cells to be replaced with fibroblasts occurs in the heart because of a deficiency of which one of the following metals?&#10;A) Selenium&#10;B) Chromium&#10;C) Silica&#10;D) Copper

Accepted Answer

Selenium deficiency can lead to cell membrane damage, resulting in the replacement of normal cells with fibroblasts in the heart. This condition is associated with Keshan disease, a cardiomyopathy linked to selenium deficiency.

Question 2

All of the following factors must be demonstrated before metal toxicity is considered a diagnosis except:&#10;A) A source of metal exposure must be evident.&#10;B) More than two organ systems must be affected.&#10;C) Typical metal overdose signs and symptoms must be shown.&#10;D) Abnormal metal concentration in the appropriate tissue must be evident.

Accepted Answer

According to the question, all factors must be demonstrated before metal toxicity is considered a diagnosis except for one. Therefore, the correct answer is the one that does not need to be demonstrated. Option B states that more than two organ systems must be affected, which is not a requirement for metal toxicity diagnosis, making it the correct answer. A source of metal exposure must be evident, typical metal overdose signs and symptoms must be shown, and abnormal metal concentration in the appropriate tissue must be evident in order to diagnose metal toxicity.

Question 3

Lead produces a serious toxic effect when ingested because it:&#10;A) irreversibly binds to heme iron in hemoglobin.&#10;B) vasoconstricts cardiac blood vessels and vasodilates peripheral vessels.&#10;C) depresses the central nervous system and induces coma.&#10;D) does not allow for the incorporation of heme into the porphyrin molecule.

Accepted Answer

Lead interferes with the synthesis of heme by inhibiting the enzymes involved in the incorporation of iron into the porphyrin molecule, leading to anemia and other toxic effects.

Question 4

What blood analyte does a toxic overdose of aluminum affect?&#10;A) Acid phosphatase&#10;B) Vitamin C (ascorbic acid)&#10;C) Lactate dehydrogenase&#10;D) Parathyroid hormone

Accepted Answer

A toxic overdose of aluminum affects the parathyroid hormone, leading to decreased levels of calcium in the blood by inhibiting its absorption from the gastrointestinal tract and increasing its excretion by the kidneys.

Question 5

MATCHING&#10;Match the metal with the analytical issue that could alter the results of analysis.&#10;Chromium&#10;A)Reduced to a nontoxic form in biological specimens&#10;B)Blood specimens are not especially useful; urine is best&#10;C)Requires a lymphocyte proliferation test; serum or urine quantification is not useful&#10;D)To examine erythrocytes,EDTA-anticoagulated blood is specimen of choice

Accepted Answer

Chromium is reduced to a nontoxic form in biological specimens.

Question 6

A byproduct of zinc and lead smelting,this metal is also used in the production of rechargeable batteries.Chronic exposure to this metal results in renal damage and breathing its fumes causes pulmonary congestion resembling chronic emphysema.

A) Beryllium
B) Copper
C) Cadmium
D) Aluminum

Accepted Answer

Cadmium is a byproduct of zinc and lead smelting and is used in the production of rechargeable batteries. Chronic exposure to cadmium can result in renal damage and pulmonary congestion resembling chronic emphysema. The other metals listed do not have these specific health effects associated with them.

Question 7

A four-member family of fish-loving vegetarians has become ill and visits their family practitioner.Their symptoms include stumbling (ataxia),visual field loss,and urinary difficulties.No Mees' lines are observed.Being environmentally conscious,they have their home examined for toxic gases.All tests are negative.Based on their history and symptoms,what toxic metal might be to blame?

A) Cadmium
B) Iron
C) Arsenic
D) Mercury

Accepted Answer

The symptoms described are typical of mercury poisoning, which can be caused by the consumption of contaminated fish. The absence of Mees' lines rules out arsenic poisoning, and iron and cadmium toxicity do not typically cause these specific symptoms.

Question 8

Certain metals are essential for life at low concentrations and typically function as protein cofactors required for enzymatic reactions.These particular elements are located in which group(s)and row(s)of the periodic table?

A) Groups 6 through 12,row 4
B) Groups 1 and 2,rows 3 and 4
C) Group 1,row 5
D) Groups 13 through 16,rows 4 through 6

Accepted Answer

The essential metals for life are typically transition metals, which are found in Groups 6 through 12 and Row 4 of the periodic table. These include elements such as iron, copper, zinc, and manganese, which are required for various biological functions such as oxygen transport, electron transfer, and DNA synthesis.

Question 9

Which one of the following is a toxic metal that produces Mees' lines upon overdose exposure by denaturing keratin in fingernails?&#10;A) Aluminum&#10;B) Arsenic&#10;C) Chromium&#10;D) Gadolinium

Accepted Answer

Arsenic is a toxic metal that, upon an overdose, can produce Mees' lines in fingernails. This is caused by the denaturation of the keratin in the nails. The other options listed are also toxic metals, but they do not cause Mees' lines in the same way that arsenic does.

Question 10

MATCHING&#10;Match the metal with the analytical issue that could alter the results of analysis.&#10;Beryllium&#10;A)Reduced to a nontoxic form in biological specimens&#10;B)Blood specimens are not especially useful; urine is best&#10;C)Requires a lymphocyte proliferation test; serum or urine quantification is not useful&#10;D)To examine erythrocytes,EDTA-anticoagulated blood is specimen of choice

Accepted Answer

Beryllium exposure is best assessed using a lymphocyte proliferation test, as serum or urine quantification is not useful for this metal.

Question 11

MATCHING&#10;Match the metal with the analytical issue that could alter the results of analysis.&#10;Lead&#10;A)Reduced to a nontoxic form in biological specimens&#10;B)Blood specimens are not especially useful; urine is best&#10;C)Requires a lymphocyte proliferation test; serum or urine quantification is not useful&#10;D)To examine erythrocytes,EDTA-anticoagulated blood is specimen of choice

Accepted Answer

The answer of MATCHING&#10;Match the metal with the analytical issue...

Question 12

An individual is admitted to the hospital with markedly increased liver enzymes (transferases)and unusual behavioral changes noted by her family.A protein electrophoresis reveals decreased ceruloplasmin.Which one of the following toxic metals might be implicated in this individual's symptoms?

A) Beryllium
B) Copper
C) Aluminum
D) Lead

Accepted Answer

The answer of An individual is admitted to the hospital...

Question 13

In blood collection for chromium or other trace metal analysis,what aspect of specimen collection is critical?&#10;A) Timing of the blood draw,whether morning or afternoon&#10;B) Use of serum and not plasma&#10;C) Using specially manufactured collection tubes with unique stoppers&#10;D) Using a special tourniquet that does not cause hemolysis

Accepted Answer

The answer of In blood collection for chromium or other...

Question 14

When reporting the results of a urine metal analysis,such as urine chromium,how are the results reported?&#10;A) In millimoles of drug per liter of urine per 24 hours&#10;B) As micrograms of metal per milliliter of urine in a random specimen&#10;C) In concentration units of the metal of interest per gram of creatinine&#10;D) As milligrams of metal/deciliter of urine

Accepted Answer

The answer of When reporting the results of a urine...

Question 15

MATCHING&#10;Match the metal with the analytical issue that could alter the results of analysis.&#10;Arsenic&#10;A)Reduced to a nontoxic form in biological specimens&#10;B)Blood specimens are not especially useful; urine is best&#10;C)Requires a lymphocyte proliferation test; serum or urine quantification is not useful&#10;D)To examine erythrocytes,EDTA-anticoagulated blood is specimen of choice

Accepted Answer

The answer of MATCHING&#10;Match the metal with the analytical issue...

Question 16

A four-member family of vegetarians has become ill and visits their family practitioner.Their symptoms include stumbling (ataxia),visual field loss,and urinary difficulties.No Mees' lines are observed.Based on their symptoms and knowledge of the correct metal involved,what is the best therapy?

A) British anti-Lewisite (BAL)
B) Erythropoietin
C) Chelation therapy
D) Keratin

Accepted Answer

The answer of A four-member family of vegetarians has become...

Question 17

Both mercury and arsenic produce their symptoms of toxicity in a similar way.This includes:&#10;A) deposition in bone causing interruption of physiological calcium exchange.&#10;B) strong acid formation when dissolved in water leading to tissue toxicity.&#10;C) binding to the sulfhydryl groups of protein causing loss of protein activity.&#10;D) formation of protein adducts leading to protein denaturation in alveoli.

Accepted Answer

The answer of Both mercury and arsenic produce their symptoms...

Question 18

What is the specimen of choice for determining arsenic exposure in an individual and why?&#10;A) Urine is the specimen of choice because arsenic is concentrated in and excreted predominantly by kidneys.&#10;B) Whole blood is the specimen of choice because blood concentrations remain elevated for at least 48 hours after exposure.&#10;C) Serum is the specimen of choice because arsenic moves into the serum phosphate pool and is easily measured with phosphate.&#10;D) Plasma is the specimen of choice because arsenic attaches to coagulation factors and affects clotting times best assayed in a plasma sample.

Accepted Answer

The answer of What is the specimen of choice for...

Deck 32: Toxic Metals