Assessment and Posttest Instructions
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Introduction
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Posttest
Choose the correct answers. There may be more than one correct answer for each question.
- The following clinical sequelae may result from chronic exposures to cadmium
- Sensory neuropathy in hands and feet.
- Renal damage.
- Impaired lung function.
- Loss of hearing at high frequencies.
- Bone fractures.
- Which of the following statements are true?
- Municipal waste incinerators can be a source of airborne cadmium.
- Cadmium accumulates in the food chain.
- Cigarette smoke is a source of cadmium.
- Iron deficiency may decrease a person’s risk of cadmium toxicity.
- Like lead, cadmium accumulates mostly in bones and teeth.
- Clues to the diagnosis of chronic cadmium poisoning may include
- Hepatomegaly.
- Frank wrist drop.
- Hyperthyroidism.
- Yellow tooth discoloration.
- Increased excretion of β2-microglobulin.
- The effect of cadmium on the kidney
- Can lead to increased urinary excretion of β2-microglobulin.
- Can be associated with both renal tubular damage and decreased GFR.
- May be worse in cigarette smokers.
- Is treatable by chelation.
- Leads to increased density of the renal shadow on flat plate of the abdomen.
- Treatment for acute cadmium poisoning by inhalation may include
- Oxygen.
- Fluid replacement.
- Hemodialysis.
- Peritoneal dialysis.
- Urinary acidification.
- The body systems or organs affected by chronic cadmium exposure may include
- Olfactory epithelium.
- Kidneys.
- Adrenals.
- Reproductive.
- Skeletal.
- Cadmium toxicity might be suspected in
- Rubber workers.
- Solderers.
- Battery makers.
- Jewelry fabricators.
- Tree sprayers.
- Cadmium is a natural element that is classified as a transition metal. Its chemical properties include which of the following?
- Is a lustrous blue-tinted solid.
- Produced in association with zinc production.
- Commonly occurs in a +2 oxidation state.
- All of the above.
- Which of the following statements regarding the biologic fate of cadmium in the body are true
- Cadmium is transported in the blood bound to metallothionein.
- The greatest cadmium concentrations are found in the kidneys and the liver.
- Urinary cadmium excretion is slow; however, it constitutes the major mechanism of elimination.
- Due to slow excretion, cadmium accumulates in the body over a lifetime and its biologic half-life may be up to 38 years.
- All of the above.
- Certain factors can increase the absorption or body burden of cadmium.
- Younger age.
- Non-smoking.
- Pregnancy.
- All of the above.
- None of the above.
- During the exposure history, the key to including chronic cadmium intoxication in the differential diagnosis is
- A history or smoking tobacco.
- A history of febrile illnesses.
- Recent physical exercise.
- The use of nephrotoxic medications.
- Detailed questioning regarding occupations and hobbies.
- Workers in certain industries are generally exposed to higher levels of cadmium than the general populations since
- Cadmium air levels can be thousands of times higher in the workplace than in the community.
- Workers have lower levels of smoking than the general population.
- Ingestion is the main route of exposure in the workplace.
- None of the above.
- The workup for a patient with an acute inhalation exposure to cadmium includes
- An exposure history.
- Physical exam with emphasis on the respiratory system.
- Chest X-ray.
- Pulse oximetry.
- In order to detect renal disease from higher than average chronic exposures to cadmium, one should:
- Look for yellow discoloration of teeth.
- Order a thorough panel of renal tests including electrolytes, BUN, serum and urinary creatinine, and urinary proteins such as β2-microglobulin and RBP.
- Order a set of skeletal X-rays.
- Order a chest X-ray.
- Advice the physician can give the patient in order to prevent further exposures to cadmium include
- Avoid eating, drinking, and smoking in the workplace.
- Eat large amounts of cereal grains and sweetmeats.
- Exercise.
- None of the above.
Relevant Content
To review content relevant to the posttest questions, see:
Question | Location of Relevant Content |
---|---|
1 | What diseases are associated with chronic exposure to cadmium? |
2 | Where is cadmium found? What are routes of exposure for cadmium? |
3 | What diseases are associated with chronic exposure to cadmium? |
4 | What diseases are associated with chronic exposure to cadmium? |
5 | How should patients exposed to cadmium be treated and managed? |
6 | What diseases are associated with chronic exposure to cadmium? |
7 | Who is at risk of cadmium exposure? |
8 | What is cadmium? |
9 | What is the biologic fate of cadmium in the body? |
10 | What factors increase the risk of developing disease from exposure to cadmium? |
11 | Clinical assessment – History and physical examination |
12 | What are the routes of exposure for cadmium? |
13 | Clinical assessment – History and physical examination Clinical assessment – Laboratory tests |
14 | Clinical assessment – Laboratory tests |
15 | What instructions should be given to patients exposed to cadmium? |