Step 1

Pharmacology 4

A 34-year-old woman is brought to the emergency department by a friend with confusion and altered mental status. Her past medical history is significant for schizophrenia but is otherwise unremarkable. The friend reports that she does not drink alcohol. Her initial vitals are temperature 39.5°C (103.1°F), blood pressure 139/90 mm Hg, heart rate 110 beats/minute, and respirations 19/minute. Electrocardiogram is significant for sinus tachycardia without any other acute changes. Physical examination is significant for confusion, tachycardia, diffuse muscle rigidity.

Which of the following is the most likely cause of this patient’s condition?

  • A) Acute alcohol withdrawal
  • B) Amphetamine overdose
  • C) Heroin overdose
  • D) Malignant hyperthermia
  • E) Neuroleptic malignant syndrome


Kevin Patel


Dr. Ted O'Connell