Nucleated red blood cells with basophilic stippling are associated with poisoning by which metal?

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Prepare for the Toxicology E3R Exam with interactive quizzes. Test your knowledge with multiple choice questions, each complete with explanations to ensure understanding. Enhance your readiness and excel on your exam!

Multiple Choice

Nucleated red blood cells with basophilic stippling are associated with poisoning by which metal?

Explanation:
Basophilic stippling reflects impaired breakdown of ribosomal RNA in developing red blood cells. Lead disrupts heme synthesis by inhibiting the enzymes ALA dehydratase and ferrochelatase, which blocks proper heme formation and allows ribosomal RNA fragments to persist, producing that stippled appearance. In response to toxic marrow stress, immature nucleated red blood cells can be released into the circulation, giving nucleated red cells as well. Taken together, this combination is classically linked to lead poisoning, making it the best match. Arsenic, mercury, and cadmium don’t produce this pattern as reliably.

Basophilic stippling reflects impaired breakdown of ribosomal RNA in developing red blood cells. Lead disrupts heme synthesis by inhibiting the enzymes ALA dehydratase and ferrochelatase, which blocks proper heme formation and allows ribosomal RNA fragments to persist, producing that stippled appearance. In response to toxic marrow stress, immature nucleated red blood cells can be released into the circulation, giving nucleated red cells as well. Taken together, this combination is classically linked to lead poisoning, making it the best match. Arsenic, mercury, and cadmium don’t produce this pattern as reliably.

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