A 25-Year-Old Man Is Brought to the Emergency Department Due

question 255

Multiple Choice

A 25-year-old man is brought to the emergency department due to severe agitation and aggressive behavior.  He speaks loudly and rapidly, stating that he has "superpowers" of mind control and that violence is the only way to defend against "the conspiracy."  The patient has a history of bipolar disorder and is prescribed olanzapine, lithium, and fluoxetine, although it is unclear if he has been compliant.  The patient requires several doses of medication in the emergency department to calm down and is subsequently admitted to the hospital for further psychiatric evaluation.  The following night he is found lying very still on his bed and does not respond to questions.  Temperature is 40.6 C (105.1 F) , blood pressure is 157/90 mm Hg, pulse is 102/min, and respirations are 20/min.  Examination is significant for diaphoresis and diffuse rigidity in upper and lower extremities.  Which of the following is the most likely explanation for this patient's current symptoms?

• A)Acute dystonic reaction
• B)Akathisia
• C)Drug-induced parkinsonism
• D)Lithium toxicity
• E)Neuroleptic malignant syndrome
• F)Serotonin syndrome

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Definitions:

America

Often used to refer to the United States, a country consisting of 50 states, a federal district, five major self-governing territories, and various possessions.

Protest

A public demonstration of objection, disapproval, or dissent towards an idea or action, often involving gatherings, marches, or rallies.

1830

The year marked by significant global events, including revolutions in Europe advocating for more democratic governments and the start of the French colonization of Algeria.