Question:
A 30 year old male presents with a history of consumption of some unknown substance. The attending doctor notices the person to be having diaphoresis, headache and acute coronary spasm like features. The person is least likely to show which clinical feature?
A 30 year old male presents with a history of consumption of some unknown substance. The attending doctor notices the person to be having diaphoresis, headache and acute coronary spasm like features. The person is least likely to show which clinical feature?
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Think about the sympathomimetic effects of cocaine -- which vital sign change would be opposite to what cocaine causes?
Updated On: Jun 23, 2026
- Bradycardia
- Tachycardia
- Hyperthermia
- Hypertension
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The Correct Option is A
Solution and Explanation
Step 1: Identify the substance. Diaphoresis, headache, coronary artery spasm, tachycardia, hypertension and hyperthermia in a 30-year-old male strongly suggest cocaine intoxication.
Step 2: Understand cocaine's mechanism. Cocaine blocks the reuptake of norepinephrine, dopamine, and serotonin at presynaptic terminals. The resulting excess of catecholamines causes:
- Tachycardia (increased heart rate)
- Hypertension (vasoconstriction)
- Hyperthermia (increased metabolic rate -- 'Cocaine Fever')
- Coronary vasospasm
- Diaphoresis
Step 3: Apply to options. Bradycardia (slow heart rate) is the LEAST likely feature because cocaine is a sympathomimetic agent that causes tachycardia, not bradycardia. All other options (tachycardia, hyperthermia, hypertension) are expected findings in cocaine toxicity.
Step 4: Conclusion. Bradycardia is least likely to be seen.
Step 2: Understand cocaine's mechanism. Cocaine blocks the reuptake of norepinephrine, dopamine, and serotonin at presynaptic terminals. The resulting excess of catecholamines causes:
- Tachycardia (increased heart rate)
- Hypertension (vasoconstriction)
- Hyperthermia (increased metabolic rate -- 'Cocaine Fever')
- Coronary vasospasm
- Diaphoresis
Step 3: Apply to options. Bradycardia (slow heart rate) is the LEAST likely feature because cocaine is a sympathomimetic agent that causes tachycardia, not bradycardia. All other options (tachycardia, hyperthermia, hypertension) are expected findings in cocaine toxicity.
Step 4: Conclusion. Bradycardia is least likely to be seen.
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