Phloston

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From GT:

"A 34-year-old male is found in the middle of the highway screaming and talking to himself. He is brought into the emergency room where the intern obtains a history that he has been awake for several days. On examination, he has a temperature of 103.4, blood pressure of 210/100, and a heart rate of 190. Examination of his eyes shows pupillary dilatation. The intern reads the EKG taken as showing an arrhythmia. Which of the following substances is the patient likely intoxicated with?

A. Amphetamines
B. Cocaine
C. PCP-phencyclidine
D. LSD-Lysergic acid
E. Opioids"

Answer = A
-----

Is the only reason A beats B here because of the time frame (i.e. he's been awake for a few days vs cocaine, which may be more acute??)?

GT is very vague with the explanation (not surprising).

Cheers,
 
Jun 24, 2012
40
6
Georgia
Status
Pre-Medical
Well it states the patient was screaming and talking to himself. That is a symptom of stimulant psychosis, which because of the fact that amphetamines take longer to metabolize occur more commonly with amphetamine intoxication. However, it would be important to find out when this patient last ingested the alleged substance, because they could be on a major cocaine binge. Also, if you observe them for half an hour you can tell for sure whether it's cocaine or amphetamines, because with cocaine the acute effects will start to subside, but they will not if amphetamines were ingested.
 

OveractiveBrain

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From GT:

"A 34-year-old male is found in the middle of the highway screaming and talking to himself. He is brought into the emergency room where the intern obtains a history that he has been awake for several days. On examination, he has a temperature of 103.4, blood pressure of 210/100, and a heart rate of 190. Examination of his eyes shows pupillary dilatation. The intern reads the EKG taken as showing an arrhythmia. Which of the following substances is the patient likely intoxicated with?

A. Amphetamines
B. Cocaine
C. PCP-phencyclidine
D. LSD-Lysergic acid
E. Opioids"

Answer = A
-----

Is the only reason A beats B here because of the time frame (i.e. he's been awake for a few days vs cocaine, which may be more acute??)?

GT is very vague with the explanation (not surprising).

Cheers,
Opiates, off teh table, its backwards

Psychosis is associated with COcaine, PCP, and LSD, and Amphetamines

Adrenergic response (tachy and HTN) associated with Cocaine, PCP, and Amphetamines

Fever associated with Amphetamines. PCP and COcaine dont make you febrile.

Mydriasis cocaine and amphetamines

awake for several days sounds like cocaine

This is a ******edly complex problem, where every side effect is being tested. You won't get something this complex. If you can do what ive listed above, you've got the knowledge you need. Honestly, I think its the fever that gives the answer away. Other than that, I was going Cocaine, all the way. I think its an unfair question, asking you if "binge for days" or "fever" is more specific.

To me: HTN, Tachycardia, and Days awake (thus leading to psychosis) is cocaine, not Amphetamines. Maybe the fever... maybe.
 
Jun 24, 2012
40
6
Georgia
Status
Pre-Medical
Actually HYPERthermia is also associated with cocaine intoxication.

And for the record, the type of psychosis that stimulants produces is markedly different than a hallucinagenic drug of the PCP/LSD variety. Although those are both completely different entities as well.

I don't know why "a few days" would give you the impression of a cocaine binge, unless this person is extremely wealthy or has some sort of constant source most people won't go on a bender that long with cocaine.

Amphetamines have roughly a 12 hour half life, cocaine has about a 1 hour half life. Therefore the effects are going to be obvious for much longer if someone has been abusing amphetamines, even if their last ingestion was almost half a day ago.
 
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