Toxicology: pituitary failure 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.

Try it

Forensic Medicine · Toxicology: pituitary failure after viper bite

Sample item

A 35-year-old woman bitten by Russell's viper 8 months ago was treated with antivenom and recovered from renal injury. She now has amenorrhoea, fatigue, hypotension and hyponatraemia. What is the most likely cause?

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

The answer and the reasoning

D. Hypopituitarism from pituitary infarction or haemorrhage after envenomation

Russell's viper envenomation can cause pituitary haemorrhage or infarction through coagulopathy and hypotension, leading to hypopituitarism months later. Amenorrhoea, fatigue, hypotension and hyponatraemia indicate secondary adrenal, gonadal and thyroid failure, and pituitary hormone assessment is needed.

Option by option

  • A. Autoimmune thyroiditis

    Autoimmune thyroiditis would not link to the bite and would not cause adrenal failure.

  • B. Chronic kidney disease from cortical necrosis alone

    Renal failure does not explain amenorrhoea with hypotension and hyponatraemia in a recovered kidney.

  • C. Serum sickness from the antivenom

    Serum sickness occurs 1 to 2 weeks after antivenom and does not produce hormone deficits.

  • D. Hypopituitarism from pituitary infarction or haemorrhage after envenomation (correct)

    Correct. Late pituitary failure is a recognised complication of Russell's viper bite.

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 Forensic Medicine questions

Questions about this Forensic Medicine question

What is the answer to this Forensic Medicine question?

The best answer is D, Hypopituitarism from pituitary infarction or haemorrhage after envenomation. Russell's viper envenomation can cause pituitary haemorrhage or infarction through coagulopathy and hypotension, leading to hypopituitarism months later.

Why is "Autoimmune thyroiditis" not the answer?

Autoimmune thyroiditis would not link to the bite and would not cause adrenal failure.

Why is "Chronic kidney disease from cortical necrosis alone" not the answer?

Renal failure does not explain amenorrhoea with hypotension and hyponatraemia in a recovered kidney.

Why is "Serum sickness from the antivenom" not the answer?

Serum sickness occurs 1 to 2 weeks after antivenom and does not produce hormone deficits.

What concept does this question test?

It tests Toxicology: pituitary failure after viper bite in Forensic Medicine. Amenorrhoea, fatigue, hypotension and hyponatraemia indicate secondary adrenal, gonadal and thyroid failure, and pituitary hormone assessment is needed.

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: pituitary failure 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.