Case 1
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Question 1 of 3
1. Question
A 37-year-old woman with a history of bipolar affective disorder was brought into ED by relatives who were concerned that she was confused and agitated. She had apparently been started on a different combination therapy a few weeks previously although her relatives are unsure of her medications. Her sister stated that she had noticed that she had been tremulous over the past 3 days and had become confused and agitated over the past 24 hours.
On examination she is sweating, tachycardic, agitated, verbally unresponsive, and febrile at 39.4.
Place the following in descending order or likelihood as the cause of her symptoms (most likely first).
Scoring: Points are deducted for incorrect selections.
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Serotonin syndrome
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CNS infection
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Anticholinergic syndrome
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Malignant hyperthermia
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Neuroleptic malignant syndrome
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Question 2 of 3
2. Question
What do you expect to find on neurological examination?
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Question 3 of 3
3. Question
Which specific therapy might be indicated in this patient if not responding to supportive measures?
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