A patient presents to the emergency depament with bluish discolouration of conjunctiva, mucus membranes and nails one hour after ingestion of a poison. Examination reveals tachycardia and hypotension. Which of the following is the most likely ingested substance?: (A) Mercury, (B) Arsenic, (C) Lead, (D) Silver
Answer is B. Presence of bluish discolouration of conjunctiva, mucus membranes and nails suggests cyanosis. Cyanosis together with peripheral vascular failure and shock within one hour of ingestion of a poison suggests Acute Arsenic poisoning of the Fulminant type. Ref: The Essentials of Forensic Medicine and Toxicology By K.S Narayan Reddy, 29th Edition, Page 482; Recognition and Management of Pesticide Poisonings (5th Ed.) By J. Routt Reiga, Pages 127-30