Lead Poisoning – Board-Style Questions

What this deck covers

Lead poisoning in 18 board-style clinical cases with worked explanations. Each case gives you a clinical vignette, four options, the correct answer, and an explanation of why each of the other three is wrong, with the guideline or textbook it follows named on the answer.

Board-style teaching questions for paediatricians and trainees preparing for paediatric board, MRCPCH and licensing examinations. Written from published guidelines and standard paediatric textbooks, with the source named on every answer.

The 18 cases, in order

1. Dust in the hallway
2. Which needle, which tube
3. Blue specks in the cells
4. Bands at the knees
5. Two drugs, one order
6. Why one comes first
7. Not sick enough for a drip
8. The other deficiency
9. Up again at the review
10. What the future holds
11. Back to the same room
12. Who else lives there
13. Cleaning it safely
14. A gift from the aunt
15. Seen on the abdominal film
16. What the urine shows
17. The hand that will not lift
18. A grumbling belly

Diagnoses and management options tested

Across the 18 cases you are asked to choose between options such as: A copper water pipe that has been in place since the house was built, A venous sample, because a fingerprick is contaminated by skin dust, Sickled cells with target forms and a raised reticulocyte count, Layers of new bone laid down along the shaft of the femur, Dimercaprol first, with the second agent added some hours later, The first drug must be given on an empty stomach to be absorbed, A single dose of activated charcoal, repeated the following day, Correcting it prevents the rash that the chelating drug causes, Stored metal moves out of the bone and the level climbs again, The drug reverses the damage already done to his development, The drug can only be given in hospital and he is well, Repeat his own level once a year until he starts school, Wet wiping and covering the surface rather than dry sanding, The formula milk, which is made up with tap water.

Clinical pearls from this deck

• Disturbed old paint is the source until proved otherwise.
• Screen on a fingerprick, confirm on a venous sample.
• Small cells, adequate iron, stippling: think metal.
• Dense bands at the metaphysis mean long exposure.
• Encephalopathy: dimercaprol first, then the second drug.
• The order protects the brain while it is mobilised.

Work through the deck once for recognition, then again a week later to test yourself — each question gives the answer and explains why every other option fails.

More from this system: all emergency and critical care case decks · pediatric reference values.