Toxicology: aconite poisoning: 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: aconite poisoning

Sample item

A man takes an herbal tonic containing Aconitum root and presents with tingling around the mouth, vomiting, palpitations and ventricular ectopics. What is the mechanism of aconitine toxicity?

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

The answer and the reasoning

D. Persistent opening of voltage-gated sodium channels

Aconitine binds to voltage-gated sodium channels and keeps them open, producing persistent depolarisation. This gives paraesthesia of the mouth and limbs, and ventricular arrhythmias, and the cardiac effects cause death. Digitalis-like glycosides act by Na-K ATPase inhibition.

Option by option

  • A. Inhibition of the sodium-potassium ATPase pump

    Na-K ATPase inhibition is the mechanism of cardiac glycosides such as oleander.

  • B. Blockade of nicotinic receptors at the neuromuscular junction

    Nicotinic blockade is the mechanism of curare and cobra venom.

  • C. Inhibition of acetylcholinesterase

    Acetylcholinesterase inhibition is the mechanism of organophosphates and carbamates.

  • D. Persistent opening of voltage-gated sodium channels (correct)

    Correct. Prolonged sodium channel activation causes the sensory and cardiac features.

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, Persistent opening of voltage-gated sodium channels. Aconitine binds to voltage-gated sodium channels and keeps them open, producing persistent depolarisation.

Why is "Inhibition of the sodium-potassium ATPase pump" not the answer?

Na-K ATPase inhibition is the mechanism of cardiac glycosides such as oleander.

Why is "Blockade of nicotinic receptors at the neuromuscular junction" not the answer?

Nicotinic blockade is the mechanism of curare and cobra venom.

Why is "Inhibition of acetylcholinesterase" not the answer?

Acetylcholinesterase inhibition is the mechanism of organophosphates and carbamates.

What concept does this question test?

It tests Toxicology: aconite poisoning in Forensic Medicine. This gives paraesthesia of the mouth and limbs, and ventricular arrhythmias, and the cardiac effects cause death. Digitalis-like glycosides act by Na-K ATPase inhibition.

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: aconite poisoning?

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.