Toxicology: sympathomimetic toxidrome: 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: sympathomimetic toxidrome

Sample item

A young man is brought agitated, with dilated pupils, profuse sweating, a temperature of 39 degrees Celsius, tachycardia and hypertension. Bowel sounds are present. Which toxidrome does he show?

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

The answer and the reasoning

A. Sympathomimetic

Cocaine and amphetamine toxicity produce agitation, mydriasis, hyperthermia, tachycardia, hypertension and sweating. Anticholinergic poisoning also produces mydriasis and hyperthermia, but the skin is dry, bowel sounds are reduced and urinary retention occurs. Cholinergic poisoning causes miosis, and opioids cause miosis with sedation.

Option by option

  • A. Sympathomimetic (correct)

    Correct. Sweating with mydriasis, hypertension and agitation points to sympathomimetic excess.

  • B. Cholinergic

    Cholinergic states give miosis, salivation and bradycardia.

  • C. Anticholinergic

    Anticholinergic states cause dry, flushed skin and reduced bowel sounds.

  • D. Opioid

    An opioid state gives sedation, miosis and slow breathing.

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 A, Sympathomimetic. Cocaine and amphetamine toxicity produce agitation, mydriasis, hyperthermia, tachycardia, hypertension and sweating.

Why is "Cholinergic" not the answer?

Cholinergic states give miosis, salivation and bradycardia.

Why is "Anticholinergic" not the answer?

Anticholinergic states cause dry, flushed skin and reduced bowel sounds.

Why is "Opioid" not the answer?

An opioid state gives sedation, miosis and slow breathing.

What concept does this question test?

It tests Toxicology: sympathomimetic toxidrome in Forensic Medicine. Anticholinergic poisoning also produces mydriasis and hyperthermia, but the skin is dry, bowel sounds are reduced and urinary retention occurs. Cholinergic poisoning causes miosis, and opioids cause miosis with sedation.

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: sympathomimetic toxidrome?

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.