Skin signs of Poisoning - 17/04/24
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1) This patient has patchy skin hyperpigmentation on her arms (shown), back, and chest. Her pertinent medical history includes water ingestion from a well over a prolonged time period. Which of the following contaminants should be suspected in the water?  *
1 point
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2)  A 29-year-old male carpenter presents to the emergency department with headaches, confusion, and prolonged episodes of vomiting and 'rice water' stools. A friend says they returned from a camping trip 1 week ago. His vitals are blood pressure 90/60 mmHg, heart rate 145 bpm, and respiratory rate 20 breaths/min. Examination demonstrates hypopigmented nodules on the palms and decreased sensation in both hands and feet. A diagnosis is established with a urine spot test. What is the most appropriate treatment for this patient? *
1 point
3) A 67-year-old man presents with a chronic skin lesion on his right palm. The physical examination shows a waxy papule with a central depression and raised borders. An excisional biopsy specimen confirms malignancy. This type of malignancy has been linked to exposure to which of the following metals?
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1 point
4)  A 45-year-old male presents to the emergency department with complaints of severe abdominal pain, vomiting, and diarrhoea. He works in the agricultural sector and mentions frequent exposure to pesticides and herbicides. Physical examination reveals diffuse abdominal tenderness and signs of dehydration. Laboratory investigations show a garlic-like odour on the breath and a high anion gap metabolic acidosis. Which of the following heavy metals is most likely responsible for his symptoms? *
1 point
5)  A 35-year-old female presents to the clinic with complaints of chronic fatigue, peripheral neuropathy, and skin lesions characterised by hyperpigmentation and hyperkeratosis. She works in a manufacturing plant where she handles various industrial chemicals. Physical examination reveals bilateral sensory deficits in the lower extremities. Laboratory investigations show elevated levels of arsenic in her urine. Which of the following heavy metals is most likely responsible for her symptoms? *
1 point
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