Toxicology: Datura poisoning: practice question

A General 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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General Medicine · Toxicology: Datura poisoning

Sample item

Children who ate thorn apple seeds have hot dry flushed skin, dilated pupils, urinary retention, tachycardia and agitated delirium. After benzodiazepines for agitation, which antidote is used for severe delirium or tachyarrhythmia?

AN-acetylcysteineBAtropineCPralidoximeDPhysostigmine

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

The answer and the reasoning

D. Physostigmine

Datura contains atropine, hyoscyamine and scopolamine, causing an anticholinergic toxidrome. Physostigmine, a reversible cholinesterase inhibitor that crosses the blood-brain barrier, reverses central and peripheral effects but is avoided in tricyclic overdose or conduction defects. Supportive care and benzodiazepines are the mainstay.

Option by option

A. N-acetylcysteine
N-acetylcysteine is the antidote for paracetamol.
B. Atropine
Atropine would worsen the toxidrome.
C. Pralidoxime
Pralidoxime reactivates cholinesterase in organophosphate poisoning.
D. Physostigmine (correct)
Correct. Physostigmine counteracts anticholinergic delirium.

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 General Medicine question

What is the answer to this General Medicine question?

The best answer is D, Physostigmine. Datura contains atropine, hyoscyamine and scopolamine, causing an anticholinergic toxidrome.

Why is "N-acetylcysteine" not the answer?

N-acetylcysteine is the antidote for paracetamol.

Why is "Atropine" not the answer?

Atropine would worsen the toxidrome.

Why is "Pralidoxime" not the answer?

Pralidoxime reactivates cholinesterase in organophosphate poisoning.

What concept does this question test?

It tests Toxicology: Datura poisoning in General Medicine. Physostigmine, a reversible cholinesterase inhibitor that crosses the blood-brain barrier, reverses central and peripheral effects but is avoided in tricyclic overdose or conduction defects. Supportive care and benzodiazepines are the mainstay.

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: Datura poisoning?

For each disease know the classic presentation, the best test, and the first-line treatment. Then use the flashcards and the other General 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.