Substance use: synthetic cannabinoid intoxication: 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 · Substance use: synthetic cannabinoid intoxication

Sample item

A 20-year-old is brought after smoking a herbal incense mixture. He is agitated, tachycardic, hypertensive and has had a seizure, and he is paranoid. His routine urine immunoassay for cannabis is negative. What best explains the negative test?

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

The answer and the reasoning

A. Synthetic cannabinoids do not cross-react with the THC immunoassay

Synthetic cannabinoids are potent full agonists at CB1 receptors, structurally unrelated to THC, so standard cannabis immunoassays miss them. They cause more severe agitation, psychosis, seizures and cardiovascular effects than natural cannabis.

Option by option

  • A. Synthetic cannabinoids do not cross-react with the THC immunoassay (correct)

    Correct. They are chemically different from THC and are not picked up by the usual screen.

  • B. He has not taken any cannabinoid

    The clinical picture strongly suggests intoxication, and a negative screen does not exclude it.

  • C. Cannabinoids are excreted only in stool

    Cannabinoid metabolites are excreted in urine, which is why urine tests are used.

  • D. The test detects only opioid metabolites

    A cannabis immunoassay targets THC metabolites, not opioids.

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.

More Psychiatry questions

Questions about this Psychiatry question

What is the answer to this Psychiatry question?

The best answer is A, Synthetic cannabinoids do not cross-react with the THC immunoassay. Synthetic cannabinoids are potent full agonists at CB1 receptors, structurally unrelated to THC, so standard cannabis immunoassays miss them.

Why is "He has not taken any cannabinoid" not the answer?

The clinical picture strongly suggests intoxication, and a negative screen does not exclude it.

Why is "Cannabinoids are excreted only in stool" not the answer?

Cannabinoid metabolites are excreted in urine, which is why urine tests are used.

Why is "The test detects only opioid metabolites" not the answer?

A cannabis immunoassay targets THC metabolites, not opioids.

What concept does this question test?

It tests Substance use: synthetic cannabinoid intoxication in Psychiatry. They cause more severe agitation, psychosis, seizures and cardiovascular effects than natural cannabis.

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 Substance use: synthetic cannabinoid intoxication?

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.