Which statement best describes a cholinergic crisis?

Which statement best describes a cholinergic crisis?

• A. It is characterized by sympathetic overactivity
• B. It results from decreased parasympathetic activity
• C. It is an overload of parasympathetic system
• D. It is caused by nicotinic receptor blockade

Answer: (C)

Cholinergic crisis happens when there is too much acetylcholine at cholinergic synapses, leading to overstimulation of both muscarinic and nicotinic receptors. Because the parasympathetic system is driven too strongly, this is best described as an overload of the parasympathetic system. You’ll see muscarinic effects such as excessive secretions, sweating, pinpoint pupils, bradycardia, bronchorrhea, bronchoconstriction, and GI cramps with diarrhea or vomiting; nicotinic effects can include muscle fasciculations and weakness due to NMJ overstimulation. This situation typically arises from acetylcholinesterase inhibition (for example, organophosphate poisoning), causing acetylcholine to accumulate at receptors. This is not about sympathetic overactivity, nor about reduced parasympathetic activity, nor receptor blockade.

Cholinergic crisis happens when there is too much acetylcholine at cholinergic synapses, leading to overstimulation of both muscarinic and nicotinic receptors. Because the parasympathetic system is driven too strongly, this is best described as an overload of the parasympathetic system. You’ll see muscarinic effects such as excessive secretions, sweating, pinpoint pupils, bradycardia, bronchorrhea, bronchoconstriction, and GI cramps with diarrhea or vomiting; nicotinic effects can include muscle fasciculations and weakness due to NMJ overstimulation. This situation typically arises from acetylcholinesterase inhibition (for example, organophosphate poisoning), causing acetylcholine to accumulate at receptors.

This is not about sympathetic overactivity, nor about reduced parasympathetic activity, nor receptor blockade.