Toxicology: reaction to antisnake venom: 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: reaction to antisnake venom

Sample item

During an infusion of polyvalent antisnake venom, a patient develops urticaria, wheeze and a fall in blood pressure. What is the immediate management?

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

The answer and the reasoning

C. Stop the infusion and give intramuscular adrenaline

These features indicate an anaphylactic or anaphylactoid reaction to antivenom. The infusion is stopped, adrenaline is given intramuscularly without delay, and antihistamines and steroids are supplementary. After recovery the antivenom can be restarted cautiously if still needed.

Option by option

  • A. Slow the infusion and give an oral antihistamine

    Slowing the infusion with an oral drug is inadequate for hypotension and wheeze.

  • B. Give atropine

    Atropine treats bradycardia and cholinergic excess, not anaphylaxis.

  • C. Stop the infusion and give intramuscular adrenaline (correct)

    Correct. Adrenaline is the first-line treatment of anaphylaxis.

  • D. Give intravenous hydrocortisone alone

    Hydrocortisone alone acts too slowly in an emergency.

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 C, Stop the infusion and give intramuscular adrenaline. These features indicate an anaphylactic or anaphylactoid reaction to antivenom.

Why is "Slow the infusion and give an oral antihistamine" not the answer?

Slowing the infusion with an oral drug is inadequate for hypotension and wheeze.

Why is "Give atropine" not the answer?

Atropine treats bradycardia and cholinergic excess, not anaphylaxis.

Why is "Give intravenous hydrocortisone alone" not the answer?

Hydrocortisone alone acts too slowly in an emergency.

What concept does this question test?

It tests Toxicology: reaction to antisnake venom in Forensic Medicine. The infusion is stopped, adrenaline is given intramuscularly without delay, and antihistamines and steroids are supplementary. After recovery the antivenom can be restarted cautiously if still needed.

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: reaction to antisnake venom?

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.