<prompt> A young female presented with consumption of some substance in the emergency department. Greenish blue froth was seen coming out of her nostrils and oral cavity. The poisoning is most likely due to which of the following?Arsenic poisoningCopper poisoningMercury poisoningLead poisoning  <response>: Ans. b. Copper poisoning Ref: Reddy 33e p547, 29e p490Greenish blue froth from nostrils and oral cavity is seen in copper poisoning.PoisoningColour of Hair and SkinArsenic As Yellow colour of skin, hair and mucous membraneQ Milk rose Brownish pigmentationQCopper Cu Jaundiced skin Green-Blue skin, hair and perspirationQ Green-Purple line of gumsQMercury Hg BrownBlack-Blue line on gumsQ with loosening of tooth and necrosis of jaw Brown deposits on anterior tens capsuleQ Mercuria lends Acrodynia Pink diseaseQLead Pb Blue stippled burtonian line on gumsQ, especially on upper jaw near dirty and infected teethCopper PoisoningCopper Cu as a metal is not poisonous. Poisonous salts include:SubstanceColorFatal DoseFatal periodCopper subacetate Verdigris, zangalBlue green15 gm1-3 daysQUsually 12-24 hours or may be up to 3-5 days or even a weekCopper sulphate blue vitriol, nila tutiaBlue30 gmVerdigris is formed by the action of vegetable acids while cooking in copper cooking utensils, which have been not properly tin lined.Acute PoisoningChronic Poisoning Symptoms start in 15-30 minutes of ingestioninhalation and include metallic taste, increased salivation, thirst, burningcolic abdomen pain, nausea, eructations and blue-green vomiting Diarrhea with liquid and brown but not bloody motions Renal failure may lead to oliguria, albuminuria, hematuria, acidosis and uremia. Hemolysis, hemoglobinuria, methhemoglobinuria, jaundice, pancreatitis, leg cramps, spasms and convulsions may occur in severe cases. Common among industrial workers e.g. metal fume fever in copper welders, histiocytic granulomatous lung and liver due to chronic inhalation of CuSO4 spray vineyard sprayers lung disease Symptom complex is called Wilsons disease, hemochromatosis, bronzed diabetes and pigment cirrhosis. Presence of copper deposits in tissues is called chalcosis. Symptoms consist of gradual anemia, purple blue-green line on gumsQ, nausea, vomiting with bluegreen vomitusQ, colic, diarrhea, malaise, peripheral neuritis, muscle degeneration and atrophy. Skin is jaundiced; urine, hair, froth, mucosa, and perspiration become green blue-greenQ. 