Question:
A patient presents to the casualty with bluish pigmentation of the conjunctiva, mucous membranes and nails. On examination there is tachycardia and hypotension within one hour of ingestion of a poison. What is the probable poisoning?
A patient presents to the casualty with bluish pigmentation of the conjunctiva, mucous membranes and nails. On examination there is tachycardia and hypotension within one hour of ingestion of a poison. What is the probable poisoning?
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Rapid shock plus bluish mucosae and nails after ingestion points to one heavy metal.
Updated On: Jun 24, 2026
- Mercury
- Arsenic
- Lead
- Copper
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Verified By Collegedunia
The Correct Option is B
Solution and Explanation
Step 1: The picture is acute poisoning with very rapid onset (within one hour) and cardiovascular collapse, namely tachycardia and hypotension.
Step 2: Among heavy metals, acute arsenic poisoning produces sudden onset features after ingestion, including severe gastrointestinal upset, cardiovascular instability with tachycardia and hypotension due to capillary leak and shock, and the characteristic bluish discoloration of the mucous membranes, conjunctiva and nails as described.
Step 3: Mercury and lead poisoning are usually more chronic and present with renal, neurological and gingival features rather than this acute one-hour cardiovascular collapse with bluish pigmentation.
Step 4: Copper poisoning causes a metallic taste, blue-green vomitus, hemolysis and hepatic and renal damage, but the constellation of rapid shock with bluish discoloration of conjunctiva, mucosa and nails best fits arsenic in this question.
Conclusion: The probable poisoning is arsenic, hence option B.
Step 2: Among heavy metals, acute arsenic poisoning produces sudden onset features after ingestion, including severe gastrointestinal upset, cardiovascular instability with tachycardia and hypotension due to capillary leak and shock, and the characteristic bluish discoloration of the mucous membranes, conjunctiva and nails as described.
Step 3: Mercury and lead poisoning are usually more chronic and present with renal, neurological and gingival features rather than this acute one-hour cardiovascular collapse with bluish pigmentation.
Step 4: Copper poisoning causes a metallic taste, blue-green vomitus, hemolysis and hepatic and renal damage, but the constellation of rapid shock with bluish discoloration of conjunctiva, mucosa and nails best fits arsenic in this question.
Conclusion: The probable poisoning is arsenic, hence option B.
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