Toxicology and antidotes: cadmium poisoning: practice question

A Pharmacology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

Try it

Pharmacology · Toxicology and antidotes: cadmium poisoning

Sample item

A 45-year-old woman who has lived for years near a zinc smelter and eaten rice grown nearby has bone pain and multiple fractures with osteomalacia. Urine shows low-molecular-weight proteinuria and glycosuria. Which toxic metal is responsible?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Cadmium

Chronic cadmium exposure damages the proximal renal tubule, causing tubular proteinuria, glycosuria and phosphate wasting, which leads to osteomalacia and fractures (itai-itai disease). Chelation is of little value and dimercaprol is avoided because it increases renal cadmium.

Option by option

  • A. Cadmium (correct)

    Correct. Cadmium causes proximal tubular injury with osteomalacia.

  • B. Lead

    Lead causes anaemia with basophilic stippling, abdominal colic and neuropathy.

  • C. Thallium

    Thallium causes painful neuropathy and alopecia after about two weeks.

  • D. Mercury

    Mercury causes tremor, gingivitis and erethism with inorganic exposure, or neurological damage with methylmercury.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More Pharmacology questions

Questions about this Pharmacology question

What is the answer to this Pharmacology question?

The best answer is A, Cadmium. Chronic cadmium exposure damages the proximal renal tubule, causing tubular proteinuria, glycosuria and phosphate wasting, which leads to osteomalacia and fractures (itai-itai disease).

Why is "Lead" not the answer?

Lead causes anaemia with basophilic stippling, abdominal colic and neuropathy.

Why is "Thallium" not the answer?

Thallium causes painful neuropathy and alopecia after about two weeks.

Why is "Mercury" not the answer?

Mercury causes tremor, gingivitis and erethism with inorganic exposure, or neurological damage with methylmercury.

What concept does this question test?

It tests Toxicology and antidotes: cadmium poisoning in Pharmacology. Chelation is of little value and dimercaprol is avoided because it increases renal cadmium.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Toxicology and antidotes: cadmium poisoning?

Learn drugs as classes, then the exception in each class that an examiner would pick. Then use the flashcards and the other Pharmacology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.