A 45-year-old industrial worker presents with irritability, excessive shyness, emotional lability, fine tremors of the fingers and tongue, and painful extremities with erythema of the feet. Which poisoning best explains this clinical triad?
- A Lead poisoning
- B Mercury poisoning ✓
- C Arsenic poisoning
- D Thallium poisoning
Correct answer: B. Mercury poisoning
Explanation
Mercury poisoning classically produces erethism (emotional lability, irritability, excessive shyness, insomnia), fine intention tremors, and acrodynia (painful, erythematous extremities, especially feet). Lead causes Burton's line, colic, and neuropathy. Arsenic causes Mees' lines and rain-drop pigmentation. Thallium causes alopecia with residual scalp hair and painful neuropathy. The combination of erethism, tremor, and acrodynia is pathognomonic for mercury.
Reference: Reddy's The Essentials of Forensic Medicine and Toxicology, 35th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.