Toxicology: chronic arsenic exposure: practice question

A Forensic Medicine question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Forensic Medicine · Toxicology: chronic arsenic exposure

Sample item

Residents of a village in the Ganga delta who drink tube-well water develop palmar and plantar hyperkeratosis and patchy hyperpigmentation. Which cancer is a recognised long-term risk of this exposure?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Squamous cell carcinoma of the skin (Bowen disease), with bladder and lung cancers

Chronic arsenic ingestion from contaminated groundwater, seen in West Bengal and Bangladesh, causes keratoses, raindrop pigmentation and Mees lines. It is carcinogenic, with skin squamous carcinoma, Bowen disease, and bladder and lung cancers.

Option by option

  • A. Osteosarcoma

    Osteosarcoma is linked to radium and ionising radiation.

  • B. Acute lymphoblastic leukaemia

    Leukaemia is associated with benzene and radiation rather than arsenic.

  • C. Pleural mesothelioma

    Mesothelioma is the characteristic cancer of asbestos exposure.

  • D. Squamous cell carcinoma of the skin (Bowen disease), with bladder and lung cancers (correct)

    Correct. Skin, bladder and lung cancers are linked to chronic arsenic exposure.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Forensic Medicine question

What is the answer to this Forensic Medicine question?

The best answer is D, Squamous cell carcinoma of the skin (Bowen disease), with bladder and lung cancers. Chronic arsenic ingestion from contaminated groundwater, seen in West Bengal and Bangladesh, causes keratoses, raindrop pigmentation and Mees lines.

Why is "Osteosarcoma" not the answer?

Osteosarcoma is linked to radium and ionising radiation.

Why is "Acute lymphoblastic leukaemia" not the answer?

Leukaemia is associated with benzene and radiation rather than arsenic.

Why is "Pleural mesothelioma" not the answer?

Mesothelioma is the characteristic cancer of asbestos exposure.

What concept does this question test?

It tests Toxicology: chronic arsenic exposure in Forensic Medicine. It is carcinogenic, with skin squamous carcinoma, Bowen disease, and bladder and lung cancers.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Toxicology: chronic arsenic exposure?

Learn postmortem changes with their timelines, and toxicology as poison, sign, test and antidote. Then use the flashcards and the other Forensic Medicine questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.