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NBME Step 2 CK Form 7 Answers

step2ck_form7/Block 4/Question#45 (reveal difficulty score)
A 32-year-old man is brought to the emergency ...
Dopamine ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
tags: psych pharm

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submitted by โˆ—step_prep5(246)
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  • Young patient with recent medication addition to treat hallucinations (most likely an antipsychotic), who has fever, encephalopathy, unstable vitals (tachycardia, hypertension), elevated CK, and muscle rigidity, all of which are most consistent with neuroleptic malignant syndrome (secondary to antipsychotics that are dopamine antagonists)
  • Serotonin syndrome: 3 Aโ€™s (Autonomic dysregulation, Agitation and increased Activity (hyperreflexia, hypertonia, tremor, etc.) in a patient taking any drug that increases serotonin (SSRIs, SNRIs, TCAs, MAO inhibitors, triptans, MDMA, dextromethorphan, meperidine, St. Johnโ€™s wort, ondansetron, tramadol, linezolid, etc.)

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