Toxicology: sea snake envenomation: 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: sea snake envenomation

Sample item

A fisherman bitten by a sea snake feels little pain, but 2 hours later develops severe generalised muscle pain, weakness and dark brown urine. Which mechanism explains this picture?

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

The answer and the reasoning

D. Myotoxic venom causing rhabdomyolysis with myoglobinuria

Sea snake venom is mainly myotoxic. It causes rhabdomyolysis with muscle pain, weakness and myoglobinuria, with risk of hyperkalaemia and acute kidney injury. Procoagulant consumption coagulopathy is typical of vipers, and neurotoxicity of elapids.

Option by option

  • A. Haemolysin causing intravascular haemolysis with haemoglobinuria

    Intravascular haemolysis is not the main feature of sea snake bites.

  • B. Venom procoagulants causing consumption coagulopathy

    Consumption coagulopathy is a feature of viper envenomation.

  • C. Presynaptic block of acetylcholine release only

    A purely presynaptic block would not cause the muscle damage and pigmented urine.

  • D. Myotoxic venom causing rhabdomyolysis with myoglobinuria (correct)

    Correct. Myotoxic venom causes muscle breakdown and dark myoglobin-rich urine.

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, Myotoxic venom causing rhabdomyolysis with myoglobinuria. Sea snake venom is mainly myotoxic.

Why is "Haemolysin causing intravascular haemolysis with haemoglobinuria" not the answer?

Intravascular haemolysis is not the main feature of sea snake bites.

Why is "Venom procoagulants causing consumption coagulopathy" not the answer?

Consumption coagulopathy is a feature of viper envenomation.

Why is "Presynaptic block of acetylcholine release only" not the answer?

A purely presynaptic block would not cause the muscle damage and pigmented urine.

What concept does this question test?

It tests Toxicology: sea snake envenomation in Forensic Medicine. It causes rhabdomyolysis with muscle pain, weakness and myoglobinuria, with risk of hyperkalaemia and acute kidney injury. Procoagulant consumption coagulopathy is typical of vipers, and neurotoxicity of elapids.

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: sea snake envenomation?

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.