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.

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General Medicine · Toxicology

Sample item

A man develops blurred vision, visual field described as 'snowstorm', abdominal pain and severe high anion gap metabolic acidosis after drinking illicit liquor. Besides sodium bicarbonate and haemodialysis when indicated, which drug blocks the toxic pathway?

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

The answer and the reasoning

C. Fomepizole

Methanol is metabolised by alcohol dehydrogenase to formaldehyde and formic acid, which cause acidosis and optic nerve toxicity. Fomepizole inhibits alcohol dehydrogenase, and ethanol can be used if it is unavailable. Folate helps formate metabolism.

Option by option

  • A. Naloxone

    Naloxone reverses opioid toxicity.

  • B. N-acetylcysteine

    N-acetylcysteine replenishes glutathione in paracetamol poisoning.

  • C. Fomepizole (correct)

    Correct. Blocking alcohol dehydrogenase prevents formation of toxic metabolites.

  • D. Flumazenil

    Flumazenil reverses benzodiazepine toxicity.

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, Fomepizole. Methanol is metabolised by alcohol dehydrogenase to formaldehyde and formic acid, which cause acidosis and optic nerve toxicity.

Why is "Naloxone" not the answer?

Naloxone reverses opioid toxicity.

Why is "N-acetylcysteine" not the answer?

N-acetylcysteine replenishes glutathione in paracetamol poisoning.

Why is "Flumazenil" not the answer?

Flumazenil reverses benzodiazepine toxicity.

What concept does this question test?

It tests Toxicology in General Medicine. Fomepizole inhibits alcohol dehydrogenase, and ethanol can be used if it is unavailable. Folate helps formate metabolism.

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.