Substance use: tolerance to opioid effects: practice question

A Psychiatry 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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Psychiatry · Substance use: tolerance to opioid effects

Sample item

A man has been taking high-dose oral opioids for years and now tolerates doses that would have been fatal to a naive user. Which effect will show the least tolerance despite this chronic use?

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

The answer and the reasoning

A. Miosis and constipation

Tolerance develops to euphoria, analgesia, sedation, nausea and respiratory depression, which explains the dose escalation. Little or no tolerance develops to pupillary constriction and constipation, so pinpoint pupils persist in chronic users.

Option by option

  • A. Miosis and constipation (correct)

    Correct. These effects persist despite long-term use.

  • B. Euphoria

    Tolerance develops quickly to euphoria, driving dose escalation.

  • C. Nausea and vomiting

    Tolerance develops to nausea and vomiting with repeated exposure.

  • D. Respiratory depression

    Tolerance develops to respiratory depression, although incompletely.

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 Psychiatry question

What is the answer to this Psychiatry question?

The best answer is A, Miosis and constipation. Tolerance develops to euphoria, analgesia, sedation, nausea and respiratory depression, which explains the dose escalation.

Why is "Euphoria" not the answer?

Tolerance develops quickly to euphoria, driving dose escalation.

Why is "Nausea and vomiting" not the answer?

Tolerance develops to nausea and vomiting with repeated exposure.

Why is "Respiratory depression" not the answer?

Tolerance develops to respiratory depression, although incompletely.

What concept does this question test?

It tests Substance use: tolerance to opioid effects in Psychiatry. Little or no tolerance develops to pupillary constriction and constipation, so pinpoint pupils persist in chronic users.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. 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 Substance use: tolerance to opioid effects?

Learn each diagnosis by its core features and its first-line treatment. Then use the flashcards and the other Psychiatry 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.