Psychopharmacology: anticholinergic toxicity: practice question

A Psychiatry 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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Psychiatry · Psychopharmacology: anticholinergic toxicity

Sample item

A patient on trihexyphenidyl and chlorpromazine develops dry mouth, dilated pupils, hot dry skin, urinary retention and confusion. This is best explained by:

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

The answer and the reasoning

C. Anticholinergic toxicity

Excessive antimuscarinic action causes dry mucous membranes, mydriasis, flushing without sweating, hyperthermia, urinary retention and delirium. Chlorpromazine and trihexyphenidyl each have anticholinergic effects, and the effects add up.

Option by option

  • A. Serotonin syndrome

    Serotonin syndrome shows diaphoresis and clonus.

  • B. Neuroleptic malignant syndrome

    NMS shows rigidity and raised CK.

  • C. Anticholinergic toxicity (correct)

    Correct. Dry skin, mydriasis and retention are anticholinergic signs.

  • D. Lithium toxicity

    Lithium toxicity shows tremor, ataxia and vomiting.

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 Psychiatry question

What is the answer to this Psychiatry question?

The best answer is C, Anticholinergic toxicity. Excessive antimuscarinic action causes dry mucous membranes, mydriasis, flushing without sweating, hyperthermia, urinary retention and delirium.

Why is "Serotonin syndrome" not the answer?

Serotonin syndrome shows diaphoresis and clonus.

Why is "Neuroleptic malignant syndrome" not the answer?

NMS shows rigidity and raised CK.

Why is "Lithium toxicity" not the answer?

Lithium toxicity shows tremor, ataxia and vomiting.

What concept does this question test?

It tests Psychopharmacology: anticholinergic toxicity in Psychiatry. Chlorpromazine and trihexyphenidyl each have anticholinergic effects, and the effects add up.

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 Psychopharmacology: anticholinergic toxicity?

Learn each diagnosis by its core features and its first-line treatment. Then use the flashcards and the other Psychiatry 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.