pharmacology q

[ddw2013]

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A 66-year-old man is brought to the emergency
department by neighbors 1 hour after the sudden
onset of progressive confusion and sleepiness.
He had just seen the physician 1 week before,
and he appeared cheerful and his usual sharp self
until he was found wandering in his neighbor's
yard the day of admission. He appears sleepy,
but he is arousable. He is oriented to person, but
not to place or time. He recalls two of three
objects after 5 minutes. He says, "There are so
many little people here. What sort of place is
this?" He then falls back asleep. Which of the
following is the most likely cause of this patient's
condition?
(A) Acute paranoid schizophrenia
(B) Arsenic poisoning
(C) Dementia, Alzheimer type
(D) New medication regimen
(E) Tertiary syphilis

D is the right answer. Can someone explain?

 

[Ismet]

Answer of elimination.

He has zero signs of paranoia, so it's not A.
If he had arsenic poisoning, he would have vomiting/diarrhea, alopecia, convulsions, etc. So it's not B.
He was perfectly fine a week ago, and Alzheimer's doesn't progress that fast, so it's not C.
Tertiary syphilis would demonstrate things like tabes dorsalis, parasthesias, loss of coordination, etc. It's not E.

Only thing left that makes sense is D. He visited the doctor a week ago, apparently changed his meds, and now he's experiencing the side effects.

 

[J ROD]

Yeah, process of elimination. Sounds like anti-musk

 

[Enzymes]

Seems like delirium secondary to the scores of of "anti" drugs that can cause it. Anyone agree?

 

[Dharma]

Seems like delirium secondary to the scores of of "anti" drugs that can cause it. Anyone agree?

i.e. tripping balls. Jamestown, VA 1705.

 

[Apoplexy__]

Seems like delirium secondary to the scores of of "anti" drugs that can cause it. Anyone agree?

Yeah.

Also, you can eliminate C and E because this is delirium, and those would cause dementia.

 

[NeuroLAX]

Remember, delirium presents with acute and fluctuating changes in consciousness with altered perception, disorientation, and poor attention. This patient has all of these symptoms. Given his age and the fact that he recently visited his physician, drugs seem to be the culprit. It's not uncommon for those >65 years to be taking 10 or more prescription medications (polypharmacy).

 

[dyspareunia]

Answer of elimination.

He has zero signs of paranoia, so it's not A.
If he had arsenic poisoning, he would have vomiting/diarrhea, alopecia, convulsions, etc. So it's not B.
He was perfectly fine a week ago, and Alzheimer's doesn't progress that fast, so it's not C.
Tertiary syphilis would demonstrate things like tabes dorsalis, parasthesias, loss of coordination, etc. It's not E.

Only thing left that makes sense is D. He visited the doctor a week ago, apparently changed his meds, and now he's experiencing the side effects.

All this, plus the thread title "pharmacology q".









😉

 

[Ismet]

All this, plus the thread title "pharmacology q".









😉

i totes missed that