Which of the following is NOT a typical feature of arsenic poisoning?

• A. Hyperkeratosis
• B. Rice water stools
• C. Garlic breath
• D. Diaphragmatic paralysis

Answer: (D)

The key idea is recognizing the spectrum of arsenic poisoning signs. Acute arsenic exposure typically causes severe gastrointestinal symptoms, including vomiting and diarrhea, with the characteristic “rice water” stools. With longer exposure, skin changes such as hyperkeratosis (thickening of the skin, especially on the palms and soles) can appear, and a garlic odor on the breath is a classic clue. Diaphragmatic paralysis, however, is not a feature you would expect from arsenic poisoning. Arsenic can cause peripheral neuropathy over time, but it does not classically lead to weakness or paralysis of the diaphragm. So the feature that does not fit arsenic poisoning is diaphragmatic paralysis.