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During a flight, a patient presents with miosis, excessive salivation, bronchorrhea, diarrhea, and muscle fasiculations. Which of the following is the most likely cause of these symptoms?
Benzodiazepine overdose
Opioid overdose
Organophosphate poisoning
Carbon monoxide poisoning
The described symptoms are characteristic of organophosphate poisoning, which results in cholinergic toxidrome. Organophosphates inhibit acetylcholinesterase, leading to an accumulation of acetylcholine and overstimulation of cholinergic receptors. The symptoms such as miosis (constricted pupils), excessive salivation, bronchorrhea, diarrhea, and muscle fasciculations are hallmark signs of cholinergic toxicity.
Other options such as benzodiazepines, opioid overdose, and carbon monoxide poisoning typically present with different symptoms. Benzodiazepine overdose might lead to drowsiness and respiratory depression, opioid overdose often presents with miosis and respiratory depression, and carbon monoxide poisoning typically causes headache, dizziness, and cherry-red skin.
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