Toxicology and antidotes: quinine and hypoglycaemia: practice question

A Pharmacology 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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Pharmacology · Toxicology and antidotes: quinine and hypoglycaemia

Sample item

A patient with severe falciparum malaria on an intravenous quinine infusion becomes drowsy and sweaty. Which metabolic complication should be checked for first?

AHypercalcaemiaBHyperkalaemiaCDiabetic ketoacidosisDHyperinsulinaemic hypoglycaemia

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

The answer and the reasoning

D. Hyperinsulinaemic hypoglycaemia

Quinine stimulates pancreatic beta cells to release insulin, and malaria itself consumes glucose, so hypoglycaemia is common, especially in pregnancy. Blood glucose should be monitored and treated promptly. Cinchonism, with tinnitus, headache and blurred vision, is the other classic effect.

Option by option

A. Hypercalcaemia
Hypercalcaemia is not a feature of quinine therapy.
B. Hyperkalaemia
Hyperkalaemia is not a characteristic effect of quinine.
C. Diabetic ketoacidosis
Ketoacidosis is not seen, because insulin secretion is raised.
D. Hyperinsulinaemic hypoglycaemia (correct)
Correct. Quinine-stimulated insulin release causes hypoglycaemia.

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.

Questions about this Pharmacology question

What is the answer to this Pharmacology question?

The best answer is D, Hyperinsulinaemic hypoglycaemia. Quinine stimulates pancreatic beta cells to release insulin, and malaria itself consumes glucose, so hypoglycaemia is common, especially in pregnancy.

Why is "Hypercalcaemia" not the answer?

Hypercalcaemia is not a feature of quinine therapy.

Why is "Hyperkalaemia" not the answer?

Hyperkalaemia is not a characteristic effect of quinine.

Why is "Diabetic ketoacidosis" not the answer?

Ketoacidosis is not seen, because insulin secretion is raised.

What concept does this question test?

It tests Toxicology and antidotes: quinine and hypoglycaemia in Pharmacology. Blood glucose should be monitored and treated promptly. Cinchonism, with tinnitus, headache and blurred vision, is the other classic effect.

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 and antidotes: quinine and hypoglycaemia?

Learn drugs as classes, then the exception in each class that an examiner would pick. Then use the flashcards and the other Pharmacology 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.