WBR0367
| Author | [[PageAuthor::[User:Gonzalo Romero]] |
|---|---|
| Exam Type | ExamType::USMLE Step 1 |
| Main Category | MainCategory::Pharmacology |
| Sub Category | SubCategory::Cardiology, SubCategory::Dermatology, SubCategory::Gastrointestinal |
| Prompt | [[Prompt::A 25-year-old male patient comes to the clinic complaining of fatigue for over 4 weeks. The student states that this begun after a teacher assigned a project to each class member a group project to be discussed and presented at a conference in 6 months. He feels frightened about standing in front of a big crowd. Upon examination his vitals are: 124/80mmHg, HR: 120, RR: 21, Temp: 37C. The patient looks fidgety and has a rapid speech. The patient is prescribed the drug of choice for this disorder. After 2 he months he decides to increase the dose and starts developing diarrhea, wheezing and flushing. Which of the following could be used to treat this patient’s new symptoms?]] |
| Answer A | AnswerA::Cyproheptadine |
| Answer A Explanation | [[AnswerAExp::Correct. Cyproheptadine is used to treat the management of moderate to severe cases of serotonin syndrome. This excess of serotonin can be caused by SSRIs excess, MAO Inhibitors intoxication and carcinoid tumor.]] |
| Answer B | AnswerB::Glucagon |
| Answer B Explanation | [[AnswerBExp::Incorrect. Glucagon is used to reverse the intoxication of Betablockers.]] |
| Answer C | AnswerC::Flumazenile |
| Answer C Explanation | [[AnswerCExp::Incorrect. Flumazenile reverses the effects of benzodiazepines.]] |
| Answer D | AnswerD::Naloxone |
| Answer D Explanation | [[AnswerDExp::Incorrect. Naloxone is used to reverse acute intoxications with Opioids.]] |
| Answer E | AnswerE::Sodium bicarbonat |
| Answer E Explanation | [[AnswerEExp::Incorrect. Sodium bicarbonate alkalinizes the urine allowing the elimination of acidic substances in the urine by inhibiting the reabsorption. It can be used in cases of Salicylates and TCAs intoxication.]] |
| Right Answer | RightAnswer::A |
| Explanation | [[Explanation::This patient is presenting with Social phobia, also known as Social Anxiety Disorder. The treatment of choice of phobias short term include Beta blockers, such as Propranol and cognitive therapy. SSRIs which increase the are prescribed long term to treat to underlying anxiety. After a course of 2 months with treatment this patient is presenting with cutaneous flushing, diarrhea, and wheezing; typical characteristics of serotonin syndrome. This syndrome is due to an excess of serotonin. The treatment of choice for serotonin syndrome Cyproheptadine, a first generation antihistamine with anticholinergic, antiserotoninergic and local anesthetic properties.
|
| Approved | Approved::Yes |
| Keyword | |
| Linked Question | Linked:: |
| Order in Linked Questions | LinkedOrder:: |