mohamed.ali
Forum Junior
Topics: 12
Posts: 39
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22. A 24-year-old man is brought to the emergency department by police 1 hour after his ex-wife found him stumbling around in 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
) Intravenous administration of 50% dextrose
D
) Intravenous administration of lorazepam
E
) Oral administration of chlorpromazine
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what do u think ? I'd run for D
is it right ?
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| GOGETA
I'm Dr. GOGETA
Topics: 303
Posts: 2,657
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Pupils examination rules out opiods so IM naloxe is out
Observation only is not correct because you have to do something and his BP is 100/70
Dextrose looks promising to start and then give the Vit. B
for oral clorpromazine interesting
beacuse 10% of patient could die from delirium trememns lorazepam is the initial tx, but there is no reference of tremor, I would go with this one.
If not my second choice will be E
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As a general rule, the better it felt when you said it, the more trouble it's going to get you into.
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| mohamed.ali
Forum Junior
Topics: 12
Posts: 39
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yes ..I completely agree with u
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| shahnaz.r
Forum Junior
Topics: 6
Posts: 72
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Hey...sounds like this Gentleman has taken Canabis["Ganja psychosis"/marijuana];
Clue: injected conjuctiva, mild paranoia and broad affect,no violance, no terrible sympathetic or parasympathetic findings.
I'd prefer to observe that guy in the ER. So I'll go for A.
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| Miradautas Vras
Forum Senior
Topics: 8
Posts: 154
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Agree with shehnaz
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Man who fights too long against the dragons becomes a dragon himself.
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| guangyu
Forum Elite
Topics: 29
Posts: 308
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agree, and 100/70 is normal for some guys.
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