A patient presents to emergency with pinpoint pupil, salivation, lacrimation, tremors and red tears. Plasma cholinesterase level was 30% of normal. Most probable Diagnosis is:
Ans. (A) Organophosphate poisoning(Ref: Katzung 12/e p110)These are characteristic features of anti-cholinestearse (organophosphate and carbamate) poisoning.Features of Organophosphate poisoning:* Muscarinic symptoms: Pin point pupil, salivation, lacrimation, urination, defecation, gastrointestinal distress, vomiting, bronchospasm, bradycardia* Nicotinic symptoms: Fasciculations and fibrillations of muscle, tachycardia, tachypnea* CNS symptoms: Temors, giddiness, ataxia, coma* Red tears: Due to accumulation of porphyrin in the lacrimal glands
Organophosphate poisoning
Datura poisoning
Opioid poisoning
Pontine hemorrhage
A.N.S.