Question

A factory worker presents with excessive salivation, blue lines on gums, tremors, disturbed personality, insomnia and loss of appetite. The most likely poisoning is:

• A. Mercury
• B. Lead
• C. Arsenic
• D. Phosphorus

Hint:

Tremor plus erethism plus heavy salivation is one classic metal triad.

Answer 1

The Correct Option is A

The trick here is to read the symptom list as a single syndrome rather than a set of loose findings. We have a worker with heavy salivation, fine shaking, altered behaviour, sleeplessness and poor appetite. That combination is the recognised chronic mercury picture, built on three pillars: a characteristic tremor, the psychiatric state called erethism (shyness, irritability, insomnia, memory and personality change) and oral disease with excess salivation. A gum line can appear too. All of that maps onto mercury, so option A wins. The distractors each carry a more typical fingerprint that does not match. Lead is famous for the Burton blue line on the gums, yet its real story is abdominal colic, wrist drop, anaemia with basophilic stippling and encephalopathy, without the salivation-erethism combination. Arsenic favours gastrointestinal upset with rice-water stools, skin changes such as raindrop pigmentation and hyperkeratosis, plus Mees lines on the nails. Phosphorus tends to produce garlicky breath, vomiting and progressive liver injury. None of these reproduce the salivation, tremor and personality triad of the stem. $A$ is correct. \[\boxed{\text{Mercury}}\]