MDcooper
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40 yr old man comes to ER with seizures,He has headache,nausea,vomiting.Medical h/o insulin dependent DM,tobacco abuse,alchohol abuse and schizoaffective disorder.Medications include:insulin,haloperidol,benztropin and lithium.Pt appears confused and has alchohol on his breath.Physical exam reveals ophisthotonus and resting tremors.
labs are normal except for increased blodd glucosewhich of the following is the likely cause of seizure?
a.DKA
b.delirium tremors
c.hypoglycemia
d.neuroleptic induces extrapyramidal syndrome
e.lithium toxicity
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| Guptashutosh
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D. neuroleptic indused eps
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| MDcooper
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this is what I thought too,but the answer is lithium toxicity.a very new concept for me,
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| webjeee
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I think the problem of choice d. neuroleptic induces extrapyramidal syndrome is the choice itself, not neuroleptic induces, but Antipsychotics induces neuroleptic disorders.
Copyright ©2006 The McGraw-Hill Companies. All rights reserved.
Tintinalli's Emergency Medicine > Section 14: Toxicology and Pharmacology > Chapter 162. Lithium > Clinical Effects >
Table 162-2 Side Effects with Chronic Lithium Therapy
Neurologic Fine tremor* Fatigue* Poor memory Loss of concentration Dysphoria Muscle weakness Decreased reaction time Lack of spontaneity Worsening of dementia Truncal ataxia Ataxic gait Dysarthria Extrapyramidal symptoms (cogwheeling) Renal Polyuria* Atrophy of nephron Decreased ability to concentrate urine Nephrogenic diabetes insipidus Inhibition of antidiuretic hormone Incomplete distal renal tubular acidosis Cardiovascular* T-wave flattening or inversion U waves Prolonged QT interval Sinus bradycardia Sinoatrial block First-degree atrioventricular block Endocrine Increased thyroid-stimulating hormone and decreased T4 and T3 (hypothyroid effect) Euthyroid goiter Increased calcium and parathyroid hormone Increased magnesium Weight gain Increased glucose Gastrointestinal Anorexia* Nausea and vomiting* Diarrhea* Abdominal pain Dermatological Maculopapular rash* Psoriasis Acne Folliculitis Edema of hands and feet Alopecia Miscellaneous Eye burning, itching, and tearing Increased white blood cell count
*Common.
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| ssrpk
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i was confused between d and e!
but don't hv sufficient reason to favor one over the other!
whtz the explanation for this q mdcooper
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