Asphyxial deaths: delayed sequelae of carbon monoxide: 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 · Asphyxial deaths: delayed sequelae of carbon monoxide

Sample item

A man is rescued from a smoke-filled room and recovers fully. Two weeks later he becomes confused, apathetic and incontinent, with parkinsonian rigidity. MRI shows symmetrical lesions of both globus pallidus. What is the diagnosis?

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

The answer and the reasoning

C. Delayed neurological sequelae of carbon monoxide poisoning

After apparent recovery from carbon monoxide poisoning, some patients develop neuropsychiatric problems after an interval of days to weeks, with demyelination and necrosis of the globus pallidus and white matter. Features include confusion, parkinsonism and incontinence. Hyperbaric oxygen is used in selected cases.

Option by option

  • A. Persistent acute carbon monoxide encephalopathy

    The acute encephalopathy does not clear and then recur after a free interval.

  • B. Wernicke encephalopathy

    Wernicke encephalopathy follows thiamine deficiency and affects the mamillary bodies and periaqueductal region.

  • C. Delayed neurological sequelae of carbon monoxide poisoning (correct)

    Correct. A free interval followed by pallidal lesions is the classic pattern.

  • D. Central pontine myelinolysis

    Central pontine myelinolysis follows rapid correction of hyponatraemia and affects the pons.

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 C, Delayed neurological sequelae of carbon monoxide poisoning. After apparent recovery from carbon monoxide poisoning, some patients develop neuropsychiatric problems after an interval of days to weeks, with demyelination and necrosis of the globus pallidus and white matter.

Why is "Persistent acute carbon monoxide encephalopathy" not the answer?

The acute encephalopathy does not clear and then recur after a free interval.

Why is "Wernicke encephalopathy" not the answer?

Wernicke encephalopathy follows thiamine deficiency and affects the mamillary bodies and periaqueductal region.

Why is "Central pontine myelinolysis" not the answer?

Central pontine myelinolysis follows rapid correction of hyponatraemia and affects the pons.

What concept does this question test?

It tests Asphyxial deaths: delayed sequelae of carbon monoxide in Forensic Medicine. Features include confusion, parkinsonism and incontinence. Hyperbaric oxygen is used in selected cases.

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 Asphyxial deaths: delayed sequelae of carbon monoxide?

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.