A 5-year-old boy is brought to the hospital after several episodes of vomiting. The boy's mother reports that he was well with no compliant and playing at a local park prior to the onset of illness. While cleaning him after the first episode of emesis, she found several small brown mushrooms clenched in his hands and brought samples with her. The boy is otherwise healthy and takes no medications. He is intubated due to somnolence and admitted to the intensive care unit. Analysis of the mushroom samples determines that the main poison stimulates muscarinic receptors. Which of the following is the most direct effect of this poison?

Question

A 5-year-old boy is brought to the hospital after several episodes of vomiting.  The boy's mother reports that he was well with no compliant and playing at a local park prior to the onset of illness.  While cleaning him after the first episode of emesis, she found several small brown mushrooms clenched in his hands and brought samples with her.  The boy is otherwise healthy and takes no medications.  He is intubated due to somnolence and admitted to the intensive care unit.  Analysis of the mushroom samples determines that the main poison stimulates muscarinic receptors.  Which of the following is the most direct effect of this poison?

Quizplus · Accepted Answer

Eductional Objective: Activation of muscarinic receptors by acetylcholine or cholinergic agonists results in peripheral vasodilation due to synthesis of nitric oxide in endothelial cells, which leads to vascular smooth muscle relaxation (eg, hypotension).  Muscarinic receptor activation in other sites causes smooth muscle contraction.

A 5-Year-Old Boy Is Brought to the Hospital After Several