Toxicology: practice question

A General 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.

Try it

General Medicine · Toxicology

Sample item

A farmer is brought in after spraying pesticide. He has salivation, sweating, pinpoint pupils, bradycardia and muscle fasciculations. Which drug should be given first?

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

The answer and the reasoning

C. Atropine

The features are cholinergic and indicate organophosphate poisoning from acetylcholinesterase inhibition. Atropine antagonises muscarinic effects and is the first life-saving drug, titrated until secretions dry. Pralidoxime is added as an adjunct to reactivate the enzyme.

Option by option

  • A. Neostigmine

    Neostigmine is itself a cholinesterase inhibitor and would worsen the poisoning.

  • B. Pralidoxime alone without atropine

    Pralidoxime does not relieve muscarinic effects and is given in addition to atropine, not in its place.

  • C. Atropine (correct)

    Correct. It reverses the muscarinic excess, particularly bronchorrhoea and bradycardia.

  • D. Naloxone

    Naloxone reverses opioid toxicity, which causes pinpoint pupils but without salivation and fasciculations.

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.

More General Medicine questions

Questions about this General Medicine question

What is the answer to this General Medicine question?

The best answer is C, Atropine. The features are cholinergic and indicate organophosphate poisoning from acetylcholinesterase inhibition.

Why is "Neostigmine" not the answer?

Neostigmine is itself a cholinesterase inhibitor and would worsen the poisoning.

Why is "Pralidoxime alone without atropine" not the answer?

Pralidoxime does not relieve muscarinic effects and is given in addition to atropine, not in its place.

Why is "Naloxone" not the answer?

Naloxone reverses opioid toxicity, which causes pinpoint pupils but without salivation and fasciculations.

What concept does this question test?

It tests Toxicology in General Medicine. Atropine antagonises muscarinic effects and is the first life-saving drug, titrated until secretions dry. Pralidoxime is added as an adjunct to reactivate the enzyme.

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?

For each disease know the classic presentation, the best test, and the first-line treatment. Then use the flashcards and the other General 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.