A patient present to emergency with pinpoint pupil, salivation, lacrimation, tremors and red tears. Plasma cholinesterase level was 30% of normal . Most probable diagnosis is: (A) Organophosphate poisoning, (B) Datura poisoning, (C) Opioid poisoning, (D) Pontine haemorrhage
Answer is A. Refer katzung 12e p110 These are characteristic feature of anticholinesterase(organophosphorous and carbamates) poisoning features of organophosphate poisoning muscarinic symptoms: pinpoint pupil, salivation, lacrimation ,urination,defecation,gastrointestinal distress, vomiting, bronchospasm, bradycardia nicotinic symptoms: fasciculations and fibrillation of muscle, tachycardia and tachypnea CNS symptoms :Tremors, giddiness, ataxia and coma red tears: due to accumulation ofporphyrin in the lacrimal glands