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Forensic Medicine · Toxicology: paraquat
Sample itemA farmer drinks a green herbicide and develops oral ulcers and vomiting. Over the next two weeks he has progressive breathlessness and hypoxia, and later renal failure. Which delayed lesion explains the respiratory failure?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
D. Pulmonary fibrosis
Paraquat concentrates in the lungs and generates free radicals. This causes alveolar damage followed by progressive pulmonary fibrosis, and there is no specific antidote. The delayed course over days to weeks is typical.
Option by option
A. Aspiration pneumonia from gastric content
Aspiration pneumonia would appear early and does not explain the weeks-long progression.
B. Bronchospasm
Bronchospasm is typical of organophosphate poisoning and not of paraquat.
C. Pulmonary embolism
Embolism causes sudden breathlessness and is not the lesion in paraquat poisoning.
D. Pulmonary fibrosis (correct)
Correct. Paraquat leads to progressive lung fibrosis.
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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