Toxicology: chloroquine overdose: 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: chloroquine overdose

Sample item

A young woman who swallowed a large number of chloroquine tablets has hypotension, a wide QRS complex and hypokalaemia. Which treatment is traditionally added to ventilatory support to improve survival?

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

The answer and the reasoning

D. High-dose diazepam with an epinephrine infusion

Chloroquine has a quinidine-like cardiotoxic effect. Early intubation, high-dose diazepam (which has anticonvulsant and cardioprotective action in experimental work) and epinephrine are the traditional measures. Amiodarone prolongs conduction and QT further.

Option by option

  • A. Atropine bolus

    Atropine treats cholinergic bradycardia and not a quinidine-like conduction block.

  • B. Intravenous amiodarone

    Amiodarone prolongs the QT interval and worsens a conduction defect.

  • C. Flumazenil infusion

    Flumazenil antagonises benzodiazepines and has no role here.

  • D. High-dose diazepam with an epinephrine infusion (correct)

    Correct. High-dose diazepam with epinephrine is the traditional supportive combination.

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 D, High-dose diazepam with an epinephrine infusion. Chloroquine has a quinidine-like cardiotoxic effect.

Why is "Atropine bolus" not the answer?

Atropine treats cholinergic bradycardia and not a quinidine-like conduction block.

Why is "Intravenous amiodarone" not the answer?

Amiodarone prolongs the QT interval and worsens a conduction defect.

Why is "Flumazenil infusion" not the answer?

Flumazenil antagonises benzodiazepines and has no role here.

What concept does this question test?

It tests Toxicology: chloroquine overdose in Forensic Medicine. Early intubation, high-dose diazepam (which has anticonvulsant and cardioprotective action in experimental work) and epinephrine are the traditional measures. Amiodarone prolongs conduction and QT further.

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 Toxicology: chloroquine overdose?

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.