Toxicology: compartment syndrome after viper bite: 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: compartment syndrome after viper bite

Sample item

A man with a viper bite has a tense swollen leg, severe pain and an incoagulable blood. Distal pulses are present. What is the best approach?

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

The answer and the reasoning

B. Give antivenom to correct the coagulopathy and measure compartment pressure before any fasciotomy

Swelling in viper bite is usually subfascial oedema and does not need fasciotomy in most cases. Operating while the blood is incoagulable causes serious bleeding. Antivenom first, then objective compartment pressure measurement if compartment syndrome is suspected.

Option by option

  • A. Incise the bite site and apply suction

    Incision and suction are discredited and increase bleeding.

  • B. Give antivenom to correct the coagulopathy and measure compartment pressure before any fasciotomy (correct)

    Correct. Treat the coagulopathy with antivenom and confirm raised compartment pressure before cutting.

  • C. Apply a tight tourniquet above the bite

    Tourniquets are not advised in viper bites as they worsen local damage.

  • D. Immediate fasciotomy to relieve swelling

    Immediate fasciotomy in an incoagulable patient risks severe haemorrhage.

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 B, Give antivenom to correct the coagulopathy and measure compartment pressure before any fasciotomy. Swelling in viper bite is usually subfascial oedema and does not need fasciotomy in most cases.

Why is "Incise the bite site and apply suction" not the answer?

Incision and suction are discredited and increase bleeding.

Why is "Apply a tight tourniquet above the bite" not the answer?

Tourniquets are not advised in viper bites as they worsen local damage.

Why is "Immediate fasciotomy to relieve swelling" not the answer?

Immediate fasciotomy in an incoagulable patient risks severe haemorrhage.

What concept does this question test?

It tests Toxicology: compartment syndrome after viper bite in Forensic Medicine. Operating while the blood is incoagulable causes serious bleeding. Antivenom first, then objective compartment pressure measurement if compartment syndrome is suspected.

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: compartment syndrome after viper bite?

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.