A 29-year-old man with a history of schizophrenia is taken to the local Emergency Department as he is generally unwell. He is currently taking olanzapine and citalopram. On examination he is noted to have a temperature of 37.0ºC and his blood pressure is 170/100 mmHg.
Which other examination finding would best support a diagnosis of neuroleptic malignant syndrome?
Correct Answer C:
Neuroleptic malignant syndrome:
Neuroleptic malignant syndrome is a rare but dangerous condition seen in patients taking antipsychotic medication. It carries a mortality of up to 10% and can also occur with atypical antipsychotics.
Features:
A raised creatine kinase is present in most cases. A leukocytosis may also be seen.
Management:
Which one of the following side-effects is least associated with the use of levodopa?
Correct Answer E:
Levodopa:
Overview:
Adverse effects:
Which one of the following is not a recognized causes of miosis?
Correct Answer C: Holmes-Adie pupil is a benign condition most commonly seen in women. It is one of the differentials of a dilated pupil.
Causes of miosis (small pupil):
Drugs causes:
Which of the following drugs is least likely to cause peripheral neuropathy?
Correct Answer C: Trimethoprim is not listed in the BNF as causing peripheral neuropathy.
Drugs causing a peripheral neuropathy:
A 23-year-old man with difficult to control epilepsy is reviewed in clinic, four months after a change in his antiepileptic medication. He has remained seizure free but has gained 5 kg in weight since last reviewed.
Which one of the following antiepileptic drugs is most associated with weight gain?
Correct Answer B:
Sodium valproate:
Sodium valproate is used in the management of epilepsy and is first line therapy for generalized seizures. It works by increasing GABA activity.
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