Match each poison with its characteristic feature:    Column I — Poison Column II — Feature  A. Carbon monoxide poisoning 1. Smell of bitter almond  B. Organophosphorus poisoning 2. Pinpoint pupil with secretions  C. Phosphorus poisoning 3. Cherry red discoloration  D. Cyanide poisoning 4. Garlicky odour

1. A

   A. A-4, B-2, C-3, D-1

2. B

   B. A-1, B-2, C-3, D-4

3. C

   C. A-4, B-3, C-1, D-2

4. D

   D. A-3, B-2, C-4, D-1

Appeared in: INI-CET EXAM -2026

Explanation

• Carbon monoxide poisoning leads to the formation of carboxyhemoglobin, which imparts a classic cherry-red discoloration to the skin and mucous membranes.
• Organophosphorus poisoning inhibits the enzyme acetylcholinesterase, causing a cholinergic crisis. This results in symptoms like miosis (pinpoint pupils) and excessive bodily secretions (salivation, lacrimation).
• Phosphorus poisoning, particularly from elemental phosphorus, is known to produce a distinct garlicky odor on the breath, in vomitus, and feces.
• Cyanide poisoning is classically associated with the smell of bitter almonds, although the ability to detect this is genetic and not present in all individuals.

Why Other Options Were Wrong

• Option A: This option incorrectly matches Carbon monoxide with a garlicky odour (A-4) and Phosphorus with cherry red discoloration (C-3). Garlicky odour is from Phosphorus, and cherry red skin is from CO poisoning.
• Option B: This option incorrectly matches Carbon monoxide with the smell of bitter almond (A-1) and Cyanide with a garlicky odour (D-4). The smell of bitter almond is from Cyanide, and a garlicky odour is from Phosphorus.
• Option C: This option incorrectly matches Carbon monoxide with a garlicky odour (A-4), Phosphorus with the smell of bitter almond (C-1), and Cyanide with pinpoint pupils (D-2). These pairings are all incorrect based on toxicological signs.

Related Visual

Clinical Relevance

• Nursing practice connection: Prioritize focused assessment, early escalation, and real-time monitoring when managing Recognition of characteristic signs and symptoms of common types of poisoning in acute care settings.
• Recognizing the specific signs (toxidromes) of different poisonings is a critical nursing skill in the emergency department. It allows for rapid identification of the toxic agent and initiation of specific antidotes and supportive care.
• Prompt identification of organophosphate poisoning, for example, allows for the timely administration of atropine and pralidoxime, which can be life-saving.
• What if? If a patient presents with altered mental status and flushed, dry skin with dilated pupils, the nurse should suspect an anticholinergic toxidrome (e.g., from antihistamines or tricyclic antidepressants), not a cholinergic one like organophosphate poisoning. The treatment would be supportive care and possibly physostigmine, which is the opposite of atropine.

How to Approach the Question

• This is a matching question. The goal is to correctly pair each item in Column I with its corresponding item in Column II.
• Start with the poison you are most confident about. For example, many students learn that carbon monoxide causes 'cherry-red' skin. This pairs A with 3.
• Next, consider organophosphorus poisoning. Its mechanism causes a cholinergic crisis, famously resulting in pinpoint pupils and secretions. This pairs B with 2.
• Look at the remaining options. Cyanide is classically taught to smell like bitter almonds (D-1), and by elimination, Phosphorus poisoning is associated with a garlicky odour (C-4).
• Once you have determined all the correct pairs (A-3, B-2, C-4, D-1), find the option that lists this exact combination.

Concept Tested & Keywords

• Concept Tested: Recognition of characteristic signs and symptoms of common types of poisoning.
• Stem keywords: Carbon monoxide poisoning, Organophosphorus poisoning, Phosphorus poisoning, Cyanide poisoning, characteristic feature
• Lead-in keywords: Match
• Negative lead-in flag: false

Question ID

QDqiGzjeJ2lJk7I_n2lxh6

Copy ID

Reference Book

E6 Nelson Textbook of Pediatrics(2024) — Volume 1 p. 746-748

E6 Textbook of Biochemistry for medical StudentsDM Vasudevan Part 2 — Subpart A (pp 1-239 of 478) p. 206-208

E6 Nelson Textbook of Pediatrics(2024) — Volume 2 p. 2260-2262