Which combination of signs indicates exposure to a nerve agent?

Which combination of signs indicates exposure to a nerve agent?

• A. Coughing, sweating, nausea
• B. Fever, chills, rash
• C. Salivation, pinpoint pupils, diarrhea
• D. Headache, dizziness, fainting

Answer: (C)

Nerve agents cause a cholinergic toxidrome by inhibiting acetylcholinesterase, which leads to excess acetylcholine at muscarinic receptors. This produces classic muscarinic signs such as excessive secretions, sweating, and GI activity, as well as pinpoint pupils (miosis). The combination of salivation, pinpoint pupils, and diarrhea directly reflects muscarinic overstimulation and is a hallmark pattern of organophosphate nerve agent exposure. The other options do not show this distinctive cluster of muscarinic symptoms; fever, chills, and rash point more to infection or an allergic reaction, while headache, dizziness, and fainting are nonspecific and not diagnostic of cholinergic toxidrome. Recognizing this specific sign set helps prompt rapid protective actions and decontamination in a suspected exposure.

Nerve agents cause a cholinergic toxidrome by inhibiting acetylcholinesterase, which leads to excess acetylcholine at muscarinic receptors. This produces classic muscarinic signs such as excessive secretions, sweating, and GI activity, as well as pinpoint pupils (miosis). The combination of salivation, pinpoint pupils, and diarrhea directly reflects muscarinic overstimulation and is a hallmark pattern of organophosphate nerve agent exposure. The other options do not show this distinctive cluster of muscarinic symptoms; fever, chills, and rash point more to infection or an allergic reaction, while headache, dizziness, and fainting are nonspecific and not diagnostic of cholinergic toxidrome. Recognizing this specific sign set helps prompt rapid protective actions and decontamination in a suspected exposure.