USMLE-Rx Step 2 Qmax Challenge #21093

Check out today’s Step 2 CK Qmax Question Challenge.

Know the answer? Post it in the comments below! Don’t forget to check back for an update with the correct answer and explanation (we’ll post it in the comments section below).

A 32-year-old woman is brought to the emergency department because of a change in mental status. Her companion states the patient recently began taking an antipsychotic for her “brain problems.” Her temperature is 39.4°C (103°F) and she is diaphoretic, flushed, and difficult to engage in conversation. Her creatine phosphokinase level is 5000 U/L and her WBC count is 9000/mm³.

After stopping the offending agent, which of the following is the next step in management?

A. Benztropine
B. Bromocriptine
C. Haloperidol
D. Lorazepam
E. Quetiapine


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13 thoughts on “USMLE-Rx Step 2 Qmax Challenge #21093”

  1. A
    Drug-induced Parkinsonism are symptomatically managed by giving anticholinergics (Trihexyphenidyl, Benztropine, Procyclidine). When under control she should be given Atypical Antipsychotics (Clozapine, Aripiprazole, Quetiapine) to minimize such side-effects.

  2. Not sure if a 32 yrs old female has Parkinsonism. It is a” change in mental status” . She was prescribed an antipsychotic for “brain problems ” and developed SE

  3. Sorry Change in opinion
    I would now go for (B)
    Should be treated with Bromocriptine/Amantadine or Dantrolene

  4. Ans s B..neurolept malignant syndrome. .s/e of antipsycotics..presents with fever, encephalopathy, rabdomyolysis, muscle rigidity
    Treated wit dantrolene and dopamine agonists lik bromocriptine

  5. Bromocriptine, my immediate response. This patient has a high fever,diaphoretic, flushed. This gives the diagnosis and then the subsequent treatment is automatic.

  6. NMS (neuroleptic malignant syndrome): rigidity, myoglubinuria, fever, autonomic instability. Treatment: dopamine agonists like bromocriptine, or dantrolene. So answer is B.

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