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Seasonal influenza vaccination — MCCQE Part 1 MCQ

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EasyPreventive MedicineSeasonal influenza vaccinationMCCQE Part 1

A 3-year-old has pica and mild speech delay. His family is renovating a house built in 1955, and he often plays beside sanding dust from peeling interior paint. He has no abdominal pain, encephalopathy or other acute toxicity. Which investigation best assesses the suspected environmental exposure?

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Correct answer: A — A venous blood lead level with focused nutritional assessment

Pica and renovation dust from a pre-1960 home create a credible lead-exposure pathway, and low-level toxicity in children is often asymptomatic or presents subtly with developmental or behavioural concerns. The Canadian Paediatric Society identifies a venous blood lead level as the gold-standard test for recent exposure. A focused history, developmental assessment, CBC, ferritin, calcium and nutritional review may accompany it, and any source should be identified and mitigated. Hair testing and provoked urine panels are not validated diagnostic strategies. Abdominal imaging is reserved for selected suspected ingestion of radiopaque lead objects and cannot replace blood testing.

Reference: Canadian Paediatric Society—Lead toxicity: https://cps.ca/en/documents/position/lead-toxicity