Toxicology: muscarinic mushroom poisoning: 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: muscarinic mushroom poisoning

Sample item

Within 30 minutes of eating wild mushrooms, a man has sweating, salivation, lacrimation, diarrhoea, bradycardia and small pupils. Which antidote is used?

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

The answer and the reasoning

C. Atropine

Some mushrooms, such as Inocybe species, contain muscarine and cause an early cholinergic picture, with onset within 30 minutes to two hours. Atropine blocks the muscarinic effects. Amatoxin poisoning has a delay of 6 to 12 hours before gastrointestinal symptoms and is treated differently.

Option by option

  • A. Silibinin

    Silibinin is used for amatoxin poisoning, which presents after a delay.

  • B. Flumazenil

    Flumazenil reverses benzodiazepines.

  • C. Atropine (correct)

    Correct. An early muscarinic syndrome is reversed by atropine.

  • D. Physostigmine

    Physostigmine is used for anticholinergic toxicity and would worsen this state.

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, Atropine. Some mushrooms, such as Inocybe species, contain muscarine and cause an early cholinergic picture, with onset within 30 minutes to two hours.

Why is "Silibinin" not the answer?

Silibinin is used for amatoxin poisoning, which presents after a delay.

Why is "Flumazenil" not the answer?

Flumazenil reverses benzodiazepines.

Why is "Physostigmine" not the answer?

Physostigmine is used for anticholinergic toxicity and would worsen this state.

What concept does this question test?

It tests Toxicology: muscarinic mushroom poisoning in Forensic Medicine. Atropine blocks the muscarinic effects. Amatoxin poisoning has a delay of 6 to 12 hours before gastrointestinal symptoms and is treated differently.

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: muscarinic mushroom poisoning?

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.