Thu18November0303AM 3

A 75-year-old man was admitted after being found collapsed in a garden shed surrounded by a number of empty containers.

On clinical examination the patient had small pupils, a heart rate of 50 beats per minute, and was frothing at the mouth.

Which of the following is the most likely diagnosis?

(Please select 1 option)

Organophosphorus poisoning Correct

Paraquat poisoning

Glyphosate poisoning

Creosote poisoning

Pyrethroid poisoning

Explanation

The patient has cholinergic features with a relative bradycardia, small pupils and increased salivation. This is highly suggestive of organophosphorus poisoning which is an anticholinesterase, thus prolonging the effects of acetylcholine.

Paraquat is associated with nausea, vomiting, and diarrhoea with ulceration.

Creosote is a petroleum based substance and would not have such an effect.

Glyphosate herbicides produce nausea, vomiting, and diarrhoea with a caustic effect in the mouth.

Pyrethroid is an insecticide and poisoning is rare but associated with coma, convulsions and pulmonary oedema.

Answer Statistics

1

92%

2

7%

3

2%

4

1%

Times answered: 270