Emergencies: organophosphate poisoning: practice question

A Pediatrics 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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Pediatrics · Emergencies: organophosphate poisoning

Sample item

A child exposed to pesticide has miosis, salivation, bradycardia and fasciculations. What is the primary antidote?

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

The answer and the reasoning

D. Atropine

Organophosphates inhibit acetylcholinesterase, leading to muscarinic and nicotinic excess, and atropine antagonises the muscarinic effects such as secretions and bradycardia. Pralidoxime reactivates the enzyme if given early. Decontamination is done by removing clothes and washing the skin.

Option by option

  • A. Naloxone

    Naloxone reverses opioids.

  • B. Physostigmine

    Physostigmine would worsen cholinergic toxicity.

  • C. Neostigmine

    Neostigmine would worsen it as well.

  • D. Atropine (correct)

    Correct. Atropine is the first antidote.

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 Pediatrics question

What is the answer to this Pediatrics question?

The best answer is D, Atropine. Organophosphates inhibit acetylcholinesterase, leading to muscarinic and nicotinic excess, and atropine antagonises the muscarinic effects such as secretions and bradycardia.

Why is "Naloxone" not the answer?

Naloxone reverses opioids.

Why is "Physostigmine" not the answer?

Physostigmine would worsen cholinergic toxicity.

Why is "Neostigmine" not the answer?

Neostigmine would worsen it as well.

What concept does this question test?

It tests Emergencies: organophosphate poisoning in Pediatrics. Pralidoxime reactivates the enzyme if given early. Decontamination is done by removing clothes and washing the skin.

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 Emergencies: organophosphate poisoning?

Memorise milestones and the vaccine schedule as tables and revise them often. Then use the flashcards and the other Pediatrics 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.