WBR0714
Author | PageAuthor::William J Gibson |
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Exam Type | ExamType::USMLE Step 2 CK |
Main Category | MainCategory::Pediatrics |
Sub Category | SubCategory::Poisoning |
Prompt | [[Prompt::A 7-year-old male is brought to the physician by his parents for loss of appetite, abdominal pain, lethargy and constipation that has become worse over the past several weeks. The parents have received a notification that their son’s performance in school has deteriorated during this same period. On physical exam, the physician notes thin, grey-blue lines visible along the margin of the patient’s gums. The patient’s condition is most likely caused by exposure to which of the following?]] |
Answer A | AnswerA::Arsenic |
Answer A Explanation | [[AnswerAExp::Incorrect: Arsenic poisoning is not associated with Burton's lines.]] |
Answer B | AnswerB::Manual thermometers |
Answer B Explanation | AnswerBExp::'''Incorrect:''' Mercury in manual thermometers would not cause Burton's lines. |
Answer C | AnswerC::Paint |
Answer C Explanation | [[AnswerCExp::Correct: Chronic exposure to lead in old paint can cause lead poisoning, which is characterized by reduced cognitive abilities, gastrointestinal problems, and Burton's lines.]] |
Answer D | AnswerD::Pesticides |
Answer D Explanation | [[AnswerDExp::Incorrect: Many pesticides (organophosphates) are potent neurotoxins, functioning by inhibiting the action of acetylcholinesterase (AChE) in nerve cells. They would not be responsible for Burton's lines.]] |
Answer E | AnswerE::Zinc |
Answer E Explanation | AnswerEExp::'''Incorrect:''' Zinc is not associated with Burton's lines. |
Right Answer | RightAnswer::C |
Explanation | [[Explanation::Lead-contaminated household dust from old paint is the major source of lead exposure to children in the U.S. The symptoms of chronic lead poisoning include neurological problems, such as reduced cognitive abilities associated with gastrointestinal problems, such as loss of appetite, abdominal pain, vomiting, and constipation. On physical exam, Burton’s lines are present which are thin, grey-blue lines visible along the margin of the patient’s gums. Although the most important part of treating lead poisoning is decreasing exposure to lead, there are some forms of chelation therapy that can be used to reduce existing blood lead levels, such as DMSA, EDTA, or British anti-Lewisite.
Educational objective: Chronic exposure to lead in old paint can cause lead poisoning, which is characterized by reduced cognitive abilities, gastrointestinal problems, and Burton's lines. |
Approved | Approved::Yes |
Keyword | WBRKeyword::Lead poisoning |
Linked Question | Linked:: |
Order in Linked Questions | LinkedOrder:: |