A 26-Year-Old Man Is Brought to the Emergency Department After

question 1106

Multiple Choice

A 26-year-old man is brought to the emergency department after collapsing 2 hours into basketball practice.  Immediately prior to collapse, the patient developed a headache and dizziness.  His parents report that he has a history of atypical depression, for which he takes quetiapine; he also underwent laparoscopic appendectomy 3 months ago.  Temperature is 41 C (105.8 F) , blood pressure is 88/48 mm Hg, pulse is 136/min, and respirations are 26/min.  The patient is disoriented but protecting his airway.  Mucous membranes are dry.  Cardiac examination shows tachycardia with a regular rhythm.  Lungs are clear bilaterally.  The abdomen is soft and nontender.  Muscle tone and reflexes are normal.  Which of the following is the best next step in management of this patient?

• A)Cold water immersion
• B)Cyproheptadine
• C)Dantrolene
• D)High-dose ceftriaxone
• E)Trendelenburg and oral hydration

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