dimps
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A 20-year-old college student is brought to the emergency department by his girlfriend because of the sudden onset of a headache, shaking, sweating, and blurry vision. She says that he became very confused during the taxicab ride over to the hospital, asking, "where are you taking me to, the airport?" He was fully aware that they were going to the hospital as they left their apartment 5 minutes earlier. These symptoms started as they were lying in bed going to sleep, 3 hours after coming back from the local Italian restaurant, where they both ate fettucine alfredo. They did not drink any alcohol tonight. He has had similar, but milder, symptoms on four previous occasions in the past few years. He has no other medical conditions and does not take any medications. His temperature is 37.0 C (98.6 F), blood pressure is 100/70 mm Hg, pulse is 120/min, and respirations are 22/min. He is not oriented to person, place, or time. He begins to lose consciousness during the physical examination, which is otherwise unremarkable. At this time the most appropriate conclusion is:
A. He should drink a glass of orange juice immediately
B. An intravenous bolus of glucose as a 50 % solution should be given immediately
C. An intravenous bolus of isotonic saline should be given immediately
D. Naloxone, given intravenously every 2 minutes, will reverse this patient's symptoms
E. Physostigmine, given intravenously over 2 minutes, will reverse this patient's symptoms
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| doc4mindia
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D. Naloxone, given intravenously every 2 minutes, will reverse this patient's symptoms
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| meg
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"doc4mindia" wrote:
D. Naloxone, given intravenously every 2 minutes, will reverse this patient's symptoms
I dont know what fettucine alfredo contain, but I suppose we can rule out opiod and muscarinic poisoning.
In opiod poisoning, respiratory rate will not be 22.
In muscarinic, they will be dry, not sweating.
I am not sure about hypoglycemic state, but I suppose it strongly here and suggest giving the glucose (B) as hypoglycemia is always fatal and needs emergent action.
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| dimps
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meg ur reasoning r great .....answer is B
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| meg
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:oops: thanks
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