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Problem-Based Learning - Coggle Diagram
Problem-Based Learning
Important information from the case
• 7 year old boy having difficulty of walking and seemed quite tired
• Vomiting
• The house he lived in was built in 1920s and was in renovation
• His conjunctiva and mucous membranes are pale
• His Neurologic examination is significant for an ataxic gait (clumsiness)
• A complete blood count (CBC) shows him to be anemic
• A serum lead level is markedly elevated
• His treatment was started with dimercaprol and ethylenediaminetetraacetic acid (EDTA)
Organic and Inorganic Lead Poisoning
Organic Lead Poisoning
• Tetraethyl was the organic lead
• Tetramethyl lead is the form of lead used to raise the octane rating in leaded petrol
• Targets the central nervous system causing neurocognitive deficits, insomnia, delirium, hallucinations, tremor, convulsions, and death.
• Treatments consists of decontaminating the skin and preventing further exposure
• Treatment of seizures requires anti-convulsants
Inorganic Lead Poisoning
• Present in paint, dust, dirt, and different consumer goods with higher lead content
• Diagnosis of lead intoxication is best by measuring lead in whole blood
• Treatment of inorganic lead poisoning involves immediate termination of exposure, supportive care, judicious use of chelation therapy
• Intramuscular injection of dimercaprol and EDTA are the most common treatment for lead encephalopathy
Classification of acute and chronic lead poisoning
Chronic Lead Poisoning
• Usually persist beyond six months
• Can cause intellectual disability, seizure disorders, violent conduct disorders, developmental regression, chronic abdominal pain, and anemia.
Acute Lead Poisoning
• Typically resolves in less than six months
• In inorganic lead poisoning, it results from industrial inhalation, or ingestion of large oral dose of lead in small children.
• Can cause irritability, reduced concentration and acute encephalopathy