Step 2

Psychiatry 12

A two-year-old girl is brought to the emergency department by ambulance for acute somnolence and disorientation. The patient was being cared for by her elderly aunt when she was found lying in the hallway. Vital signs are temperature 37°C (98°F), heart rate 90 beats/minute, blood pressure 72/37 mmHg, and respirations 12/minute and shallow. On physical examination, the patient is obtunded with minimal responses to painful stimuli. Pupils are equal, round, reactive to light, and constricted bilaterally. Skin is warm and dry with no signs of bruising, rash, or other lesions.

Which of the following is the most appropriate treatment?

  • A) Cyproheptadine
  • B) Dantroline
  • C) Flumazenil
  • D) Fomepizole
  • E) Naloxone


Miles McIntosh


Dr. Ted O'Connell