<prompt> A farmer with pinpoint pupils, increased secretions and urination. What is the most likely diagnosis?Organophosphate poisoningOpioid poisoningAlcohol poisoningAtropine poisoning  <response>: The above clinical findings are suggestive of OPC poisoning. Organophosphate poisoning OPC poisoning - OPC compounds - Parathion follidol Methyl parathion Malathion HETP, TEPP Diazinon Tik 20 Smell - Kerosene like due to presence of Aromax MOA - Inhibits Acetylcholinesterase enzyme Clinical features - Muscarinic Nicotinic SLUDGE BBB Monday - Mydriasis S - Salivation Tuesday - Tachycardia L - Lacrimation Red tears Wednesday - Weakness of muscles U - Urination Thursday - Hypeension D - Diarrhoea Friday - Fasciculations G - GIT upset E - Emesis B - Bronchospasm B - Blurring of vision Constricted pupil B - Bradycardia Diagnosis - Check the Cholinesterase enzyme levels - True Cholinesterase RBC Pseudocholinesterase - Correlates with Clinical features - Sensitive 2. Para nitrophenol test - Done for Parathion poisoning Rx - Decontamination Atropine i.v Blocks the muscarinic effects Oximes Acetylcholinesterase enzyme reactivator - Pralidoxime Suppoive Rx 