Emergency medicine: scorpion sting: 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 · Emergency medicine: scorpion sting

Sample item

A child stung by a red scorpion in rural Maharashtra develops profuse sweating, hypertension, tachycardia, priapism and early pulmonary oedema. Which drug is the treatment of choice?

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

The answer and the reasoning

D. Prazosin

Mesobuthus tamulus venom causes an autonomic storm from sodium channel effects, producing massive catecholamine release with hypertension, pulmonary oedema and myocarditis. The alpha-blocker prazosin counteracts the vasoconstriction and improves outcome. Beta-blockers worsen pulmonary oedema by unopposed alpha effects, and atropine and adrenaline are unhelpful.

Option by option

  • A. Atropine

    Atropine adds to the tachycardia and does not treat the catecholamine surge.

  • B. Adrenaline

    Adrenaline would aggravate hypertension and pulmonary oedema.

  • C. Propranolol

    Propranolol can precipitate worse cardiac failure and is avoided.

  • D. Prazosin (correct)

    Correct. Prazosin antagonises the alpha-adrenergic effects of the envenomation.

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 General Medicine question

What is the answer to this General Medicine question?

The best answer is D, Prazosin. Mesobuthus tamulus venom causes an autonomic storm from sodium channel effects, producing massive catecholamine release with hypertension, pulmonary oedema and myocarditis.

Why is "Atropine" not the answer?

Atropine adds to the tachycardia and does not treat the catecholamine surge.

Why is "Adrenaline" not the answer?

Adrenaline would aggravate hypertension and pulmonary oedema.

Why is "Propranolol" not the answer?

Propranolol can precipitate worse cardiac failure and is avoided.

What concept does this question test?

It tests Emergency medicine: scorpion sting in General Medicine. The alpha-blocker prazosin counteracts the vasoconstriction and improves outcome. Beta-blockers worsen pulmonary oedema by unopposed alpha effects, and atropine and adrenaline are unhelpful.

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 Emergency medicine: scorpion sting?

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.