Autonomic nervous system: muscarine mushroom poisoning: practice question

A Pharmacology 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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Pharmacology · Autonomic nervous system: muscarine mushroom poisoning

Sample item

A man develops profuse sweating, salivation, lacrimation, small pupils and a pulse of 48 per minute within an hour of eating wild mushrooms. Which drug reverses these effects?

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

The answer and the reasoning

B. Atropine

Mushrooms of the Inocybe and Clitocybe species contain muscarine, a direct muscarinic agonist. Atropine blocks the muscarinic receptors and reverses the cholinergic features.

Option by option

  • A. Physostigmine

    Physostigmine inhibits cholinesterase and would worsen the picture.

  • B. Atropine (correct)

    Correct. The poison is a direct muscarinic agonist, which atropine blocks.

  • C. Neostigmine

    Neostigmine would increase acetylcholine and worsen the picture.

  • D. Pralidoxime

    Pralidoxime reactivates phosphorylated cholinesterase and is useless against a direct agonist.

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 Pharmacology question

What is the answer to this Pharmacology question?

The best answer is B, Atropine. Mushrooms of the Inocybe and Clitocybe species contain muscarine, a direct muscarinic agonist.

Why is "Physostigmine" not the answer?

Physostigmine inhibits cholinesterase and would worsen the picture.

Why is "Neostigmine" not the answer?

Neostigmine would increase acetylcholine and worsen the picture.

Why is "Pralidoxime" not the answer?

Pralidoxime reactivates phosphorylated cholinesterase and is useless against a direct agonist.

What concept does this question test?

It tests Autonomic nervous system: muscarine mushroom poisoning in Pharmacology. Atropine blocks the muscarinic receptors and reverses the cholinergic features.

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 Autonomic nervous system: muscarine mushroom poisoning?

Learn drugs as classes, then the exception in each class that an examiner would pick. Then use the flashcards and the other Pharmacology 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.