vnty
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A 24-year-old man is brought to the emergency department by police 1 hour after his ex-wife found him stumbing around the yard. His blood pressure is 100/70 mm Hg, pulse is 90/min, and respirations are 16/min. The pupils are equal and reactive to light; the sclerae are injected. During the examination, he laughs without obvious reason, makes religious statements, and asks if there is anything to eat or drink. Mental status examination shows a broad range of affect; there is no evidence of thought disorder except for mild paranoia. Which of the following is the most appropriate next step in management?
a. Observation in the emergency department
b. intramuscular administration of naloxone
c. IV 50% dextrose
d. IV lorazepam
e. oral chlorpromazine
What is the diagnosis?
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| mazinger
Forum Guru
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The diferential diagnosis of this patient is hard, since we should be considering many factors. A 24 year old male, with bizarre and delusional behavior. Does this patient have something organic? or is it toxic?
Well, something organic think of schizo, in favor of schizo would be the age, gender, delusions and behavior, against it would be that the patient has broad range of affect instead of flat or blunted.
Something in favor of toxic, I am thinking of marihuana use are the injected sclerae and the fact that hes having the munchies (craving for food). So I would definite go for this diagnosis.
Treatment? If the patient is not agressive, doesnt need of restraints, nor agitated, then I would go for observation.. Wait till he clears all the trash he ate in a brownie or smoked in a pot...
Vnty whats your answer?
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original mazinger z
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| frank100
Forum Guru
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I would choose (a) too
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| MAZI
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HI
I THINK THAT HE HAS CANABICOID TOXICITH ( paranoia, scleral injection, stable vital sign )
D IV LORAZEPAM
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| mazinger
Forum Guru
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Well, IV lorazepam is maily used for seizures, it can also be used as a sedative-anxiolytic drug via sublingual, IM routes.. The patient is delusional with mild paranoia. Mazi, (I dont know the answer) are these enough criteria to give a sedative drug to this patient?
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original mazinger z
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| MAZI
Forum Elite
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i found that
you are right mazinger
the correct answer is A
THANK YOU
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| AAAAA
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vnty wrote:
A 24-year-old man is brought to the emergency department by police 1 hour after his ex-wife found him stumbing around the yard. His blood pressure is 100/70 mm Hg, pulse is 90/min, and respirations are 16/min. The pupils are equal and reactive to light; the sclerae are injected. During the examination, he laughs without obvious reason, makes religious statements, and asks if there is anything to eat or drink. Mental status examination shows a broad range of affect; there is no evidence of thought disorder except for mild paranoia. Which of the following is the most appropriate next step in management?
a. Observation in the emergency department
b. intramuscular administration of naloxone
c. IV 50% dextrose
d. IV lorazepam
e. oral chlorpromazine
What is the diagnosis?
The correct answer is observation in the emergency department
the diagnosis is psychosis ! Drug-induced psychosis (Brief)
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| mazinger
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You are welcome MAZI, Im glad I can be of help, right AAAAA?
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