USMLE Forum Archives - USMLE Step 3 - altered mental status
altered mental status
bingousmle - 06-18-10 06:54
A 74-year-old lethargic woman is brought to the ED by her family. Her daughter states that the patient has been progressively somnolent over the last week and could not be woken up today. The patient takes medications for diabetes, hypertension, hypothyroidism, and a recent ankle sprain, which is treated with a hydrocodone/acetaminophen combination. In the ED, the patient is profoundly lethargic, responsive only to pain, and has periorbital edema and delayed relaxation of the deep tendon reflexes. Her BP is 145/84 mm Hg, HR is 56 beats per minute, temperature is 94.8°F, and RR is 12 breaths per minute. Which of the following is the most likely diagnosis?
a. Hypoglycemia
b. Opioid overdose
c. Stroke
d. Myxedema coma
e. Depression
bingousmle - 06-18-10 06:54
A 74-year-old lethargic woman is brought to the ED by her family. Her daughter states that the patient has been progressively somnolent over the last week and could not be woken up today. The patient takes medications for diabetes, hypertension, hypothyroidism, and a recent ankle sprain, which is treated with a hydrocodone/acetaminophen combination. In the ED, the patient is profoundly lethargic, responsive only to pain, and has periorbital edema and delayed relaxation of the deep tendon reflexes. Her BP is 145/84 mm Hg, HR is 56 beats per minute, temperature is 94.8°F, and RR is 12 breaths per minute. Which of the following is the most likely diagnosis?
a. Hypoglycemia
b. Opioid overdose
c. Stroke
d. Myxedema coma
e. Depression
The correct answer and explanation will be available after you answer.
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#3
Re: altered mental status babbu5508 - 06-18-10 14:35 My answer is: b.
hopefully, the symptoms are likely of an opioid overdose.Naloxone is very effective at reversing symptoms due to an opioid overdose
#6
Re: altered mental status abuzic - 07-23-10 05:15 My answer is: d.
The symptoms/signs are typical (periorbital edema and delayed relaxation of tendon reflexes)
The use of hydrocodone
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