Multiple Choice Questions (MCQ)

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Category: Critical Care Medicine-Pharmacology and Toxicology--->Psychoactive Medications
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Question 1# Print Question

A 55-year-old male with a past history of alcohol use disorder with a previous history of withdrawal seizures, hypertension, and cirrhosis presents to the emergency room requesting inpatient detoxification. The patient has been drinking 12 beers daily for the past 2 weeks. His initial lab work demonstrates a glomerular filtration rate >60, AST of 210 U/L, ALT of 152 U/L.

Which of the following agents would be the best choice to use for this patient’s alcohol detoxification?

A. Chlordiazepoxide
B. Diazepam
C. Clorazepate
D. Clonazepam
E. Lorazepam

Question 2# Print Question

A 19-year-old male presents to the emergency department with agitation, altered mental status, and muscle rigidity. According to his girlfriend, his physician started him on a medication 2 weeks ago for schizophrenia and depression. During the clinical examination, he appears diaphoretic and has no clonus. His vital signs include a blood pressure of 185/90 mm Hg, temperature of 38.7°C, and pulse of 105 bpm. His lab data are significant for leukocytosis and elevated liver transaminases.

Which of the following medications is most likely causing the patient’s severe adverse reaction?

A. Olanzapine 30 mg once daily
B. Lithium 150 mg twice daily
C. Bupropion 100 mg twice daily
D. Clomipramine 25 mg once daily
E. Chlordiazepoxide 5 mg three times daily

Question 3# Print Question

An 85-year-old patient is brought into the emergency room, after he was found comatose at home by his son. The patient has a known history of bipolar disorder and epileptiform seizures and is on medication for that. Vital examination reveals:

  • BP of 112/56 mm Hg
  • pulse rate of 96 bpm
  • respiratory rate of 24 breaths/min,
  • temperature of 36.7°C

His serum sodium is 115 mmol per liter.

Which of the following medications is the most likely cause of his sodium imbalance?

A. Lithium
B. Olanzapine
C. Carbamazepine
D. Quetiapine
E. Topiramate

Question 4# Print Question

A patient presents to the ED with confusion, myoclonus, diarrhea, hypotension, altered mental status, tachycardia, and a normal creatine phosphokinase (CPK). His family is able to confirm that he was recently started on a new medication by his psychiatrist for treatment of bipolar disorder, although they do not know the name of the medication or what kind of medication it was.

Which one of the following is the most likely diagnosis and why? 

A. Neuroleptic malignant syndrome (NMS), because the patient is confused
B. NMS, because rigidity is more commonly a part of serotonin syndrome
C. Serotonin syndrome, because it commonly presents with hypertension
D. NMS, because it usually presents with normal CPK
E. Serotonin syndrome, because it more commonly presents with myoclonus and GI symptoms

Question 5# Print Question

A 37-year-old male with a past medical history of alcoholic cirrhosis presents to the ICU postoperatively, after having an open reduction and internal fixation of his femur fracture. He is currently intubated because of rib fractures, splinting, and concern for pulmonary contusions. He is currently sedated with dexmedetomidine and fentanyl infusions but is becoming more agitated and restless. The nurse requests a breakthrough dose of a benzodiazepine to keep him sedated.

Which one of the following would be the best choice of medication in someone with impaired liver function?

A. Diazepam
B. Oxazepam
C. Clonazepam
D. Prazepam
E. Estazolam

Category: Critical Care Medicine-Pharmacology and Toxicology--->Psychoactive Medications
Page: 1 of 1