A 13-year-old girl is brought in by ambulance after her friends called because she was “acting stupid”. The paramedics report that the other girls mentioned her snorting some “Vanilla Sky”.
On arrival, you see an agitated, hallucinating young girl without evidence of trauma; her glucose in the field is 122. T 37.9 HR 118 BP 142/68 RR 22 98% RA. Her general exam is significant for diaphoresis, slight tremulousness, reactive 5 mm pupils bilaterally, and a tachycardic exam. Her friends arrive soon after frantically roaming the department, offering no useful information, and quickly leaving after seeing her lying in the gurney.
Regarding her presentation, which of the following is the BEST answer:
A. Her large pupils are pathognomonic for anticholinergic toxicity
B. Her elevated heart rate indicates that she must have taken a hallucinogenic agent
C. Her diaphoresis helps to distinguish the toxidrome
D. This particular drug causes mydriasis, profound obtundation or coma, and rapid resolution
In the meantime, a quote -- "When meditating over a disease, I never think of finding a remedy for it, but, instead, a means of preventing it." --Louis Pasteur (1822-1885) Address to École Centrale des Arts et Manufactures, Paris, 1884
On arrival, you see an agitated, hallucinating young girl without evidence of trauma; her glucose in the field is 122. T 37.9 HR 118 BP 142/68 RR 22 98% RA. Her general exam is significant for diaphoresis, slight tremulousness, reactive 5 mm pupils bilaterally, and a tachycardic exam. Her friends arrive soon after frantically roaming the department, offering no useful information, and quickly leaving after seeing her lying in the gurney.
Regarding her presentation, which of the following is the BEST answer:
A. Her large pupils are pathognomonic for anticholinergic toxicity
B. Her elevated heart rate indicates that she must have taken a hallucinogenic agent
C. Her diaphoresis helps to distinguish the toxidrome
D. This particular drug causes mydriasis, profound obtundation or coma, and rapid resolution
In the meantime, a quote -- "When meditating over a disease, I never think of finding a remedy for it, but, instead, a means of preventing it." --Louis Pasteur (1822-1885) Address to École Centrale des Arts et Manufactures, Paris, 1884
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