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NBME 17 Answers

nbme17/Block 1/Question#6 (reveal difficulty score)
A 55-year-old man with chronic bronchitis is ...
Naloxone ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
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 +4  upvote downvote
submitted by โˆ—cassdawg(1780)
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The big hint here is EXTREME respiratory depression which is characteristic of opioid overdose, so he should be given naloxone. [FA2020 p570 has drug intoxication and withdrawal syndromes]

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bingcentipede  And he was also taking codeine, a mu opiod agonist. So naloxone would be able to reverse the codeine specifically. +2
schep  Flumazenil-GABA antagonist, used to treat benzodiazepine OD Fomepizole-competitive inhibitor of alcohol dehydrogenase, used to treat ethylene glycol and methanol OD hemodialysis-can be used for severe lithium ODs, not sure what else propranolol-nonselective beta blocker; not sure if it treats any ODs in particular +5
deadbeet  The HR made me waste way too much time on this question. Don't think tachycardia is the norm for opoid OD. +2
prostar  the reason for increase HR is hypotension(and the reason for hypotension is opioid induced mast cell release- histamine-vasodilation) +3



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