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
———————–
Want to know the ‘bottom line?’ Purchase a USMLE-Rx Subscription and get many more features, more questions, and passages from First Aid, including images, references, and other facts relevant to this question.
This practice question is an actual question from the USMLE-Rx Step 2 CK test bank. Get more Step 2 CK study help at USMLE-Rx.com.
C
Correction of the above .
New answer chosen : A
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.
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
Parkinsonism is one of the side-effects of Typical Antipsychotics
CK levels are also increased
Sorry Change in opinion
I would now go for (B)
Patient presents with MALIGNANT NEUROLEPTIC SYNDROME
Should be treated with Bromocriptine/Amantadine or Dantrolene
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
B clearly neuroleptic syn.
B, the one and only NMS
B Agreed correct answer
nms
bromocriptine
dantrolene can also be given
Bromocriptine, my immediate response. This patient has a high fever,diaphoretic, flushed. This gives the diagnosis and then the subsequent treatment is automatic.
NMS (neuroleptic malignant syndrome): rigidity, myoglubinuria, fever, autonomic instability. Treatment: dopamine agonists like bromocriptine, or dantrolene. So answer is B.