Toxicology: sulfonylurea overdose: 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: sulfonylurea overdose

Sample item

A diabetic man takes an overdose of glibenclamide. He has recurrent hypoglycaemia over several hours despite repeated boluses of 25 percent dextrose, with a high insulin level. Which drug reduces further insulin release?

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

The answer and the reasoning

D. Octreotide

Sulfonylureas stimulate insulin release from pancreatic beta cells, and dextrose boluses stimulate more insulin, resulting in rebound hypoglycaemia. Octreotide, a somatostatin analogue, suppresses insulin secretion and reduces the need for repeated dextrose. The other options do not address this mechanism.

Option by option

  • A. Pyridoxine

    Pyridoxine is the antidote in isoniazid poisoning.

  • B. Adrenaline infusion

    An adrenaline infusion can raise glucose temporarily but carries arrhythmia risk and does not suppress insulin.

  • C. Hydrocortisone

    Hydrocortisone has a slow, minor effect on glucose and does not stop insulin release.

  • D. Octreotide (correct)

    Correct. Octreotide inhibits the beta-cell insulin release driven by the sulfonylurea.

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, Octreotide. Sulfonylureas stimulate insulin release from pancreatic beta cells, and dextrose boluses stimulate more insulin, resulting in rebound hypoglycaemia.

Why is "Pyridoxine" not the answer?

Pyridoxine is the antidote in isoniazid poisoning.

Why is "Adrenaline infusion" not the answer?

An adrenaline infusion can raise glucose temporarily but carries arrhythmia risk and does not suppress insulin.

Why is "Hydrocortisone" not the answer?

Hydrocortisone has a slow, minor effect on glucose and does not stop insulin release.

What concept does this question test?

It tests Toxicology: sulfonylurea overdose in Forensic Medicine. Octreotide, a somatostatin analogue, suppresses insulin secretion and reduces the need for repeated dextrose. The other options do not address this mechanism.

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: sulfonylurea overdose?

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.