Crossed Words: Elements of illness

ACP Internist's puzzle feature challenges readers to find clues placed horizontally in rows to reveal an answer written vertically.

Answers to clues are placed horizontally in rows to reveal an answer written vertically. Unlike the familiar acrostic puzzle format, the final answer can be in any column (see Table).

Horizontal clues

  1. 1. Osborne waves when you feel this way
  2. 2. Hepatotoxin of the sago palm
  3. 3. Supreme Court of the U.S. decided this “individual” stays in ACA
  4. 4. Single sort of superficial skin surgery
  5. 5. Fab-ulous treatment for a drug's toxicity
  6. 6. Account for cumulative consumption e.g., pack-years
  7. 7. Skin atlas ... and there is an app for that

Find in the vertical columns: Toxin cause of the “ouch-ouch” sicknes

Answer: Cadmium

Cadmium is found in much of the environment, and the general population may be exposed to cadmium daily through food, cigarette smoke, drinking water and air. The most sensitive targets of cadmium toxicity are the kidney and bone following oral exposure, and kidney and lung following inhalation exposur (see Table 2).

The effects observed in humans include renal tubular damage, glomerular damage, decreases in bone mineralization, increased risk of bone fractures, decreased lung function, and emphysema. These effects typically occur after long term exposure to cadmium, which has a half-time in the human body of more than 26 years.