Environmental Medicine — MCQs

Q: Sweating does not occur in which of the following conditions?

Heat stroke. The core physiological distinction between heat-related illnesses lies in the status of the body’s thermoregulatory mechanisms [2]. **Heat stroke** is a life-threatening medical emergency characterized by a failure of the hypothalamic thermoregulatory center [1]. When the core body temperature rises above **40°C (104°F)**, the body's cooling mechanisms fail completely [1]. This leads to **anhidrosis** (absence of sweating), resulting in hot, dry skin. The clinical triad for heat stroke includes hyperpyrexia, anhidrosis, and altered mental status (confusion, seizures, or coma) [1]. **Why the other options are incorrect:** * **Heat exhaustion:** This is a pre-cursor to heat stroke where thermoregulation is still functional [1]. The patient experiences **profuse sweating**, dehydration, and hypotension, but the mental status remains normal [1]. * **Heat fatigue:** This is a mild, early response to heat stress characterized by lethargy and weakness. Sweating remains intact as the body attempts to dissipate heat [2]. * **Heat rash (Miliaria rubra):** This occurs due to the obstruction of sweat ducts. While localized areas of the skin may not release sweat effectively, the body’s systemic ability to sweat is not lost. **High-Yield Clinical Pearls for NEET-PG:** * **Classic Heat Stroke:** Occurs during heatwaves; typically affects elderly or sedentary individuals [1]. * **Exertional Heat Stroke:** Affects young athletes or military recruits; sweating may occasionally persist initially, but the hallmark is CNS dysfunction [1]. * **Management:** The gold standard treatment is **rapid cooling** (Ice water immersion or evaporative cooling) and aggressive fluid resuscitation [1]. * **Complication:** Rhabdomyolysis and Acute Kidney Injury (AKI) are common in exertional heat stroke.

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