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Old 09-11-2011
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Question Environmental Pathology Question

Exposure to which of the following substances lead to gastrointestinal ulceration, abdominal pain, bloody diarrhea, mouth lesions, vomiting, calcification and necrosis of renal convoluted tubules and decreased urine output?

A) Lead
B) Iron
C) Mercuric chloride
D) Ethyl glycol
E) Vinyl chloride
F) β-Naphthylamine glucuronide

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Old 09-11-2011
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sure it A lead ...
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Old 09-11-2011
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C. Mercuric chloride??
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Old 09-11-2011
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I would say Ethyl Glycol
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Old 09-11-2011
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D. Ethyl glycol
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Old 09-11-2011
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i think it's Lead poisinig - leading to Fanconi Syndrome.
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Old 09-11-2011
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C.mercuric chloride
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Old 09-12-2011
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The correct answer is (C) Mercuric chloride. Ingestion of this substance results in 1) focal GI ulcerations and 2) severe renal damage with widespread necrosis and calcification of the proximal convoluted tubules.
As mercuric salts such as mercuric chloride can not cross the blood-brain barrier easily, mercury salts inflict little neurological damage without continuous or heavy exposure.
Common symptoms of mercuric chloride poisoning:
-- Abdominal pain (severe)
-- Breathing difficulty - severe
-- Decreased urine output (may stop completely)
-- Diarrhea (bloody)
-- Drooling
-- Metallic taste
-- Mouth lesions
-- Pain in the throat and mouth - severe
-- Shock
-- Swelling in the throat - may be severe
-- Vomiting


Lead poisoning:

1- RBC changes
---
-- Basophilic stippling
----- Microcytic hypochromic anemia
2- Encephalopathy
3- Peripheral neuropathy (wrist drop, foot drop)
4- Fanconi syndrome
5- Lead line at the junction of teeth and gums
6- Increased radiosensitivity of the epiphyses of the long bones


Ethyl glycol poisoning:
1- Acute tubular necrosis
2- Tubular precipitation of calcium oxalate crystals, which can be visualized by polarized light.
3- Severe metabolic acidosis

Following ingestion the symptoms of poisoning follow a three step progression starting with intoxication and vomiting, before causing metabolic acidosis, cardiovascular dysfunction, and finally acute kidney failure. The major cause of toxicity is not the ethylene glycol itself but its metabolites. The major metabolites causing toxicity are glycolic acid and oxalic acid.
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