Question:medium
The findings in image is suggestive of which poisoning
The findings in image is suggestive of which poisoning
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Transverse white nail bands (Mees' lines) plus thick, pigmented, scaly palms point to one chronic heavy-metal poison.
Updated On: Jun 22, 2026
- OPC
- Arsenic
- Lead
- Mercury
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The Correct Option is B
Solution and Explanation
Sign-led diagnosis of the poison.
Rather than starting with the options, name the two physical signs in the photographs and ask which heavy metal owns them.
Sign 1 - transverse white nail bands: These are Mees' lines, single or multiple white lines running across the nail plate that grow out with the nail. Their single most famous cause is chronic arsenic exposure (they also occur in thallium poisoning and severe systemic illness).
Sign 2 - thick, scaly, pigmented palms: This is palmoplantar (arsenical) hyperkeratosis with hyperpigmentation, a long-term skin manifestation of arsenic, classically seen in chronic arsenic ingestion (e.g. contaminated ground water) and considered pre-malignant.
Putting the picture together: Mees' lines $+$ arsenical keratosis of the palms is a textbook chronic arsenic presentation, so the toxin is arsenic.
Why not the others:
- Organophosphate (OPC) is an ACUTE cholinergic poisoning (pinpoint pupils, secretions, fasciculations) with no chronic nail or palm signs.
- Lead shows a gingival Burton's line, basophilic stippling and motor neuropathy (wrist drop), not these nail/palm changes.
- Mercury causes tremor, erethism, salivation and, in children, acrodynia - again not Mees' lines with palmar hyperkeratosis.
So the only metal whose chronic toxicity unites both shown signs is arsenic.
Answer: B (Arsenic).
Rather than starting with the options, name the two physical signs in the photographs and ask which heavy metal owns them.
Sign 1 - transverse white nail bands: These are Mees' lines, single or multiple white lines running across the nail plate that grow out with the nail. Their single most famous cause is chronic arsenic exposure (they also occur in thallium poisoning and severe systemic illness).
Sign 2 - thick, scaly, pigmented palms: This is palmoplantar (arsenical) hyperkeratosis with hyperpigmentation, a long-term skin manifestation of arsenic, classically seen in chronic arsenic ingestion (e.g. contaminated ground water) and considered pre-malignant.
Putting the picture together: Mees' lines $+$ arsenical keratosis of the palms is a textbook chronic arsenic presentation, so the toxin is arsenic.
Why not the others:
- Organophosphate (OPC) is an ACUTE cholinergic poisoning (pinpoint pupils, secretions, fasciculations) with no chronic nail or palm signs.
- Lead shows a gingival Burton's line, basophilic stippling and motor neuropathy (wrist drop), not these nail/palm changes.
- Mercury causes tremor, erethism, salivation and, in children, acrodynia - again not Mees' lines with palmar hyperkeratosis.
So the only metal whose chronic toxicity unites both shown signs is arsenic.
Answer: B (Arsenic).
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