Environmental health: heat stroke: practice question

A PSM 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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PSM · Environmental health: heat stroke

Sample item

During a heat wave a 60-year-old farm labourer is brought in confused, with a core temperature of 41.5 degrees Celsius, hot dry skin and a pulse of 130 per minute. What is the most important immediate step?

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

The answer and the reasoning

A. Rapid whole-body cooling, for example by cold water immersion or evaporative cooling with ice packs

Heat stroke is a medical emergency defined by core temperature above 40 degrees Celsius with central nervous system dysfunction. Outcome depends on how quickly the temperature is lowered, so rapid active cooling is started at once, followed by fluids and organ support. Antipyretics are ineffective because the set point is normal.

Option by option

  • A. Rapid whole-body cooling, for example by cold water immersion or evaporative cooling with ice packs (correct)

    Correct. Prompt cooling is the life-saving step.

  • B. Oral rehydration alone with rest in the shade

    Oral fluids and rest are inadequate for a confused patient with this core temperature.

  • C. Oral paracetamol

    Paracetamol does not work because heat stroke is not caused by a raised hypothalamic set point.

  • D. Intravenous dantrolene

    Dantrolene has no proven role in classic heat stroke.

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 PSM questions

Questions about this PSM question

What is the answer to this PSM question?

The best answer is A, Rapid whole-body cooling, for example by cold water immersion or evaporative cooling with ice packs. Heat stroke is a medical emergency defined by core temperature above 40 degrees Celsius with central nervous system dysfunction.

Why is "Oral rehydration alone with rest in the shade" not the answer?

Oral fluids and rest are inadequate for a confused patient with this core temperature.

Why is "Oral paracetamol" not the answer?

Paracetamol does not work because heat stroke is not caused by a raised hypothalamic set point.

Why is "Intravenous dantrolene" not the answer?

Dantrolene has no proven role in classic heat stroke.

What concept does this question test?

It tests Environmental health: heat stroke in PSM. Outcome depends on how quickly the temperature is lowered, so rapid active cooling is started at once, followed by fluids and organ support. Antipyretics are ineffective because the set point is normal.

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 Environmental health: heat stroke?

Practise biostatistics with small calculations until sensitivity, predictive values and risk measures are automatic. Then use the flashcards and the other PSM 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.