— Medical Exam Review · QBank Platform —
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Emergency Medicine Boards
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— Sample question
A 22-year-old woman is brought to the emergency department 4 hours after a suspected overdose. She is somnolent, tachycardic (HR 138), and hypertensive (172/96). On exam, pupils are 8mm bilaterally, skin is flushed and dry, and she has diminished bowel sounds. Serum ethanol is undetectable. Urine drug screen is pending.
Which of the following is the most likely cause of this presentation?
✓ Correct answer: Anticholinergic toxicity (diphenhydramine)
Classic toxidrome: “mad as a hatter, hot as a hare, dry as a bone, red as a beet, blind as a bat.” Tachycardia, hypertension, mydriasis, flushed/dry skin, and decreased bowel sounds are pathognomonic.
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