<prompt> A farmer with long history depression on antidepressants, consumed unknown substance and presented with bradycardia, hypersalivation, small pupils. What is the most probable diagnosis?OP poisoningAtropineTCAParacetamol poisoning  <response>: Ans: A OP poisoning Ref: Harrisons Principles of internal Medicine. 18th edn.Explanation:MiosisMydriasisCholinergicsAnticholinergicsAntipsychoticsSympathomimeticsCarbamatesSSRIsOrganophosphatesSedative - hypnotics withdrawalOpioidsAlcohol Withdrawal syndromeClonidine Sedative - Hyponotics Clinical Features of Orqanophosphate PoisoningMuscarinic effectsCVS: Bradycardia , HypotensionResp: Rhinorrhea. Bronchorrhea,BronchospasmGIT: Hypersalivatioa Nausea and Vomiting, Abdominal pain. Diarrhea,Fecal incontinence. Urinary incontinenceOcular: Miosis, Blurred vision Glands: Increased lacrimation, DiaphoresisNioctinic effectsMuscle fasciculationsCrampingWeaknessDiaphragmatic paralysis Autonomic nicotinic effectsMild: Tachycardia, Hypertension, Mydriasis and pallorCNS effectsAnxietyEmotional labilityRestlessnessConfusionAtaxiaT remorsSeizuresComa 