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MMLU / A 27-year-old man is brought to the emergency department by his sister because…

Problem

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question

A 27-year-old man is brought to the emergency department by his sister because of increasing confusion for 10 hours. He is unable to answer questions. His sister states that he recently saw a psychiatrist for the first time because of hearing voices; he was prescribed a medication, but she is not sure what it is. She says that he has a history of excessive drinking, and she thinks that he has also experimented with illicit drugs. He appears acutely ill. His temperature is 39.1°C (102.3°F), pulse is 124/min, and blood pressure is 160/102 mm Hg. Examination shows profuse diaphoresis and muscle rigidity. His neck is supple. The abdomen is soft and nontender. Mental status examination shows psychomotor agitation alternating with lethargy. His leukocyte count is 15,600/mm3 , and serum creatine kinase activity is 943 U/L. Which of the following is the most likely explanation for this patient's symptoms?

choices

  1. Amphetamine intoxication
  2. Bacterial meningitis
  3. Delirium tremens
  4. Neuroleptic malignant syndrome

subject

professional_medicine

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