Toxicology: plant poisons: 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.

Try it

Forensic Medicine · Toxicology: plant poisons

Sample item

A young woman is brought in after chewing seeds of the yellow oleander (Thevetia peruviana). She has vomiting, bradycardia with heart block and hyperkalaemia. Which treatment is used for severe cardiotoxicity?

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

The answer and the reasoning

C. Digoxin-specific Fab antibody fragments

Yellow oleander seeds contain cardiac glycosides (thevetin, peruvoside) that inhibit the sodium-potassium ATPase, causing vomiting, bradyarrhythmias and hyperkalaemia as in digoxin poisoning. Activated charcoal, atropine and temporary pacing are used and digoxin-specific Fab fragments are effective in severe cases.

Option by option

  • A. Calcium gluconate in large doses

    Calcium may worsen digoxin-like toxicity and is generally avoided.

  • B. Pralidoxime

    Pralidoxime is for organophosphate poisoning.

  • C. Digoxin-specific Fab antibody fragments (correct)

    Correct. Digoxin-specific Fab binds the glycosides and corrects the toxicity.

  • D. Physostigmine

    Physostigmine treats anticholinergic poisoning and would worsen bradycardia.

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.

More Forensic Medicine questions

Questions about this Forensic Medicine question

What is the answer to this Forensic Medicine question?

The best answer is C, Digoxin-specific Fab antibody fragments. Yellow oleander seeds contain cardiac glycosides (thevetin, peruvoside) that inhibit the sodium-potassium ATPase, causing vomiting, bradyarrhythmias and hyperkalaemia as in digoxin poisoning.

Why is "Calcium gluconate in large doses" not the answer?

Calcium may worsen digoxin-like toxicity and is generally avoided.

Why is "Pralidoxime" not the answer?

Pralidoxime is for organophosphate poisoning.

Why is "Physostigmine" not the answer?

Physostigmine treats anticholinergic poisoning and would worsen bradycardia.

What concept does this question test?

It tests Toxicology: plant poisons in Forensic Medicine. Activated charcoal, atropine and temporary pacing are used and digoxin-specific Fab fragments are effective in severe cases.

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: plant poisons?

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.