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Medicine C.V.S d63578fd

Lead poisoning causes all the following Except

A
Saturnine gout
B
Sideroblastic anemia
C
Basophilic stippling
D
Macrocytic anemia
High-Yield Explanation
The major anatomic targets of lead toxicity are the bone marrow and blood, nervous system, gastrointestinal tract, and kidneys.Blood and marrow changes occur fairly rapidly and are characteristic. The inhibition of ferrochelatase by lead may result in the appearance of a few ring sideroblasts, red cell precursors with iron-laden mitochondria that are detected with a Prussian blue stain. In the peripheral blood, the defect inhemoglobin synthesis appears as a microcytic, hypochromic anemia that is often accompanied by mild hemolysis. Even more distinctive is a punctate basophilic stippling of the red cells.Brain damage is prone to occur in children In young children, sensory, motor, intellectual, and psychologic impairments have been described, includingreduced IQ, learning disabilities, retarded psychomotor development, blindness, and, in more severe cases, psychoses, seizures and coma. In adults, the CNS is less often affected, but frequently a peripheral demyelinating neuropathy appears, typically involving the motor nerves of the mostcommonly used muscles. Thus, the extensor muscles of the wrist and fingers are often the first to be affected (causing wrist-drop), followed by paralysis of the peroneal muscles (causing foot-drop).Lead "colic" is characterized by extremely severe, poorly localized abdominal pain.Kidneys may develop proximal tubular damage associated with intranuclear inclusions consisting of protein aggregates. Chronic renal damage leads eventually to interstitial fibrosis and possibly renal failure. Decreases in uric acid excretion can lead to gout ("saturnine gout").Ref: Robbins; 9th edition; Chapter 9; Environmental and Nutritional Diseases; Page no: 412

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