An industrial worker presents with blue lines on gums and tremors. What is the most probable diagnosis?
Ref: Harrison's Principles of Internal Medicine, 18th edition, chapter 49Explanation:Lead poisoning-Source-batteries, lead paints, plumbing, lead pipes.Abdominal pain, anemia with basophilic stippling, anorexia,Headache, arthralgia, myalgia, tremorsLead line (Grey blue line) at the gingival-teeth border (Burton sign)Wrist drop. cogni t i ve dee 1 i neHigh blood protoporphyrin levelTreatment-DTfSA (succimer), CuEDTA. dimercaproArsenic poisoning-Vomiting, diarrhea, abdominal pain, coma, seizuresGarlicky breath odor, hyperkeratosisMeefs lines- transverse white striae on finger nailsDistal weakness, radio-opaque on abdominal X rayECG- Prolonged QRS. QT & ST depression. T flatteningTreatment: Dimercaprol. oral succimerMercury poisoningAcute inhalation - Pneumonitis, ARDSAcute ingestion - gastroenteritis, ARF. hypertension, tachycardia, cardiovascular collapseChronic - CNS symtoms, renal failureintentional tremor, mercurial erythrism. delirium, memory loss- 'mad as a hatter *Children- acrodynia. pink diseaseTreatment- Dimercaprol. DMSA, penicillamine. Cadmium poisoning-Acute inhalation- pneumonitis. ARDSAcute ingestion- gastroenteritisChronic exposure- anosmia, yellow teeth, emphysema, anemia, CRF, osteomalaciaTreatment- supportive
Arsenic poisoning
Lead
Mercury
Carbon monoxide
Toxicology