A 45-year-old dry-cell battery manufacturing worker presents with gum line pigmentation ('Burton's line'), wrist drop, encephalopathy, and basophilic stippling on peripheral blood smear. Occupational exposure to which metal is responsible?
- A Mercury
- B Arsenic
- C Lead ✓
- D Manganese
Explanation
Lead poisoning (plumbism) is the diagnosis. The classical triad of Burton's line (blue-black lead sulfide deposit at gingival margin), wrist drop (extensor muscle palsy — radial nerve territory most affected due to predilection for motor nerves supplying extensors), and basophilic stippling (remnant ribosomal RNA aggregates reflecting impaired heme synthesis) is pathognomonic. Encephalopathy occurs in severe poisoning. Mercury causes erethism (emotional lability), Minamata disease, and acrodynia. Arsenic causes Mees' lines and Mees's lines and peripheral neuropathy. Manganism presents with Parkinson-like features, not Burton's line.
Reference: Park's Textbook of Preventive and Social Medicine, 27th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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