Will rate 5 stars if the answer is accurate and organized Hints: - it\'s not Her

Question

Will rate 5 stars if the answer is accurate and organized

Hints:

- it's not Heroin Wethdeowal or Kidney Failure

- it's related with LSD

A 28-year-old man presented to the hospital complaining of uncontrollable twitching of his extremities. He had a long history of uncomplicated intranasal heroin use and denied intravenous (IV) drug use, other substance abuse, or medical or surgical problems. He noted that he had recently changed his supplier of heroin. On examination he was found to be well developed, well nourished, and obviously uncomfortable. The vital signs were: blood pressure, 138/84 mm Hg; pulse, 110 beats/ min; respiratory rate, 24 breaths/ min; and rectal temperature, 99oF (37.2oC). Physical examination was normal except for the neurologic assessment. He was awake, alert, and fully oriented. His limbs showed irregular and bilateral spontaneous contractions, and their activity increased while he was examined. His mental status remained unchanged during these movements. Strength and sensation were within normal limits, and reflexes were brisk. Chvostek and Trousseau signs were negative.

The patient was attached to a cardiac monitor, and an IV line was inserted. Blood was sent for a complete blood count (CBC), serum electrolytes, glucose, calcium, magnesium, and creatine phosphokinase. A urinalysis was also requested. An

electrocardiogram (EKG) showed a normal sinus rhythm with normal axis and intervals and a motion artifact.

1.   What is the differential diagnosis of this patient

Explanation / Answer

1) heroine overdose, seizure

Heroin abusers, particularly those with prior history of drug abuse, may initially be able to conceal signs and symptoms of their heroin use.

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2) its not seizure because of deranged neurological assesment, and his mental status remained unchanged during these movements.

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3) heroine withdrawal syndrome

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4) Endorphins released with extensive aerobic exercise, for example, are responsible for the "rush" that long-distance runners experience. It is believed that morphine and heroin combine with the endorphin receptors in the brain, resulting in reduced natural endorphin production. As a result, the drugs are needed to replace the naturally produced endorphins and addiction occurs.

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5)

The first test should be a blood glucose level. This is one of the few times in current medicine when you can treat someone and see a therapeutic change within seconds

If a patient is obtunded, and the glucose is low, an ampule of dextrose should fix the problem.

The ECG can help with ruling TCA toxicity in or out and formulating a treatment plan.


Treatments

Patients with clinically significant respiratory compromise need treatment, which includes airway management and intravenous or subcutaneous naloxone.

Hospital observation for several hours is necessary for recurrence of hypoventilation or other complications.

Methadone maintenance is an effective preventive measure, and others strategies should be studied.

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