Psychopharmacology: serotonin syndrome: 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 · Psychopharmacology: serotonin syndrome

Sample item

Soon after adding linezolid to an SSRI, a patient develops agitation, fever, diaphoresis, diarrhea, inducible clonus, and hyperreflexia. What is the most likely diagnosis?

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

The answer and the reasoning

A. Serotonin syndrome

Serotonin syndrome is a toxidrome of serotonergic excess, often after a drug interaction, with neuromuscular hyperactivity such as clonus and hyperreflexia. It typically develops rapidly.

Option by option

  • A. Serotonin syndrome (correct)

    Correct. Clonus and hyperreflexia in a serotonergic interaction are strongly suggestive.

  • B. Anticholinergic toxicity

    Anticholinergic toxicity causes dry skin, urinary retention, and reduced bowel sounds rather than clonus.

  • C. Neuroleptic malignant syndrome

    NMS usually evolves more slowly with lead-pipe rigidity and hyporeflexia after dopamine blockade.

  • D. Lithium-induced hypothyroidism

    Hypothyroidism is a chronic endocrine adverse effect and does not produce this acute toxidrome.

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, Serotonin syndrome. Serotonin syndrome is a toxidrome of serotonergic excess, often after a drug interaction, with neuromuscular hyperactivity such as clonus and hyperreflexia.

Why is "Anticholinergic toxicity" not the answer?

Anticholinergic toxicity causes dry skin, urinary retention, and reduced bowel sounds rather than clonus.

Why is "Neuroleptic malignant syndrome" not the answer?

NMS usually evolves more slowly with lead-pipe rigidity and hyporeflexia after dopamine blockade.

Why is "Lithium-induced hypothyroidism" not the answer?

Hypothyroidism is a chronic endocrine adverse effect and does not produce this acute toxidrome.

What concept does this question test?

It tests Psychopharmacology: serotonin syndrome in Psychiatry. It typically develops rapidly.

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 Psychopharmacology: serotonin syndrome?

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.