This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Forensic Medicine
[{'content': 'Burtonian lines on gums is seen in poisoning with \nSelect and explain. \nA. Lead, B. Mercury, C. Arsenic, D. Zinc', 'role': 'user'}, {'content': 'Answer: A \nExplanation: Clinical features of chronic lead poisoning/ plumbism/saturism:\n\n\xa0Facial pallor especially around mouth is the earliest and most consistent sign\n\xa0Polycythemia with polychromatophilia followed by anemia with punctate basophilia (basophilic stippling), reticulocytosis, poikilocytosis, nucleated RBC(sideroblasts), increased neutrophils & decreased platelets are seen in early stages.\n\xa0Stippled blue line known as Burtonian or lead line is seen on gums, only near carious teeth in upper jaw as an early sign.\n\nIt is bluish black epithelial deposition of lead sulphide granules on gums. Similar blue line may also be seen in mercury;\xa0copper, silver, bismuth & iron poisoning.\n\n\xa0Colic & constipation is a late manifestation\n\xa0Paralysis, encephalopathy, cardiovascular, renal & reproductive system manifestations are late manifestations,\n\xa0Tremors, numbness, hyperesthesia & cramps preceding actual muscle paralysis more commonly involve muscle groups prone to fatigue .\n\xa0Paralysis is associated with muscle atrophy Sc nerve degeneration due to interference with resynthesis of phosphocreatinine.\n\xa0Encephalopathy is present in every case but is more common in children Sc in poisoning by tetra ethyl lead salt.\n\xa0Menstrual derangements (amenorrhoea, dysmenorrhoea, menorrhagia), abortion (between 3-6 months), dead fetus & sterility in both sexes.\n\xa0Vascular constriction due to lead results in hypertension & interstitial nephritis.', 'role': 'assistant'}]