frontal
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An 18-year-old man is brought to the emergency department by friends after he passed out and became unarousable. He has no history of medical problems. There is alcohol on his breath and no evidence of trauma. His blood pressure is 110/60 mm Hg, pulse is 70/min, and respirations are 6/min. The lungs are clear to auscultation. There is a normal S1 and S2. A grade 2/6, systolic ejection murmur is heard. The liver edge and spleen tip are not palpable. Test of the stool for occult blood is negative. Neurologic examination is difficult to assess. Reflexes are 1+ bilaterally. All extremities respond to painful stimuli. His blood alcohol level is 200 mg/dL; toxicology screening is also positive for benzodiazepines in the blood andcocaine metabolites in the urine. The patient does not respond to infusion with naloxone, glucose, or vitamin B1 (thiamine). Abuse of which of the following substances is the most likely cause of these findings?
(A) Alcohol only
(B) Alcohol and benzodiazepines
(C) Alcohol and cocaine
(D) Alcohol and PCP
(E) Alcohol and salicylates
Edited by frontal on 11/25/05 - 08:48 AM
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| frontal
Forum Guru
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Shit. I'm sorry about the terrible way the post has appeared. I most certainly didn't type those 'lefts'.
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| frontal
Forum Guru
Topics: 53
Posts: 421
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Okay, I just discovered the 'edit' option and deleted all the 'lefts'. Please explain your answer if possible.
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| ARJ
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B) Alcohol and benzodiazepines
naloxone opioid antidote
glucose, or vitamin B1 (thiamine)----alcohol
Alcohol and Benzodiazepine cause RS depression
So the drug to be given is flumazenil which is a benzodiazepine antidote for the treatment.
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| frontal
Forum Guru
Topics: 53
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Answer:B.
Keep it up, ARJ. Thank you for the explanation.
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