Which combination of symptoms indicates nerve agent exposure?

Which combination of symptoms indicates nerve agent exposure?

• A. Coughing only
• B. Mild fever and rash
• C. Salivation, pinpoint pupils, diarrhea
• D. Blurred vision only

Answer: (C)

Nerve agents inhibit acetylcholinesterase, causing a buildup of acetylcholine at muscarinic receptors and triggering a cholinergic toxidrome. The key signs are the secretions and GI effects described by SLUDGE: salivation, pinpoint pupils, and diarrhea. This specific combination reflects muscarinic overstimulation and is the best indicator of nerve agent exposure. Other options don’t fit that cholinergic pattern—coughing alone can occur for many reasons, blurred vision alone isn’t specific, and mild fever with rash doesn’t align with the cholinergic signs seen in nerve agent exposure.

Nerve agents inhibit acetylcholinesterase, causing a buildup of acetylcholine at muscarinic receptors and triggering a cholinergic toxidrome. The key signs are the secretions and GI effects described by SLUDGE: salivation, pinpoint pupils, and diarrhea. This specific combination reflects muscarinic overstimulation and is the best indicator of nerve agent exposure. Other options don’t fit that cholinergic pattern—coughing alone can occur for many reasons, blurred vision alone isn’t specific, and mild fever with rash doesn’t align with the cholinergic signs seen in nerve agent exposure.