Correlate each distinct clinical presentation observed in the acute care setting with the most accurate corresponding substance-related syndrome.
- Prominent rhinorrhea, frequent yawning, diffuse piloerection, and severe myalgias in an ambulatory patient.Opioid withdrawal syndrome
- Pronounced diaphoresis, pupillary dilation (mydriasis), resting tachycardia, and rapid, pressured speech in an agitated individual.Stimulant (e.g., cocaine or amphetamine) intoxication
- Rotary nystagmus, significant combativeness, and a striking lack of response to painful procedures in a trauma setting.Phencyclidine (PCP) intoxication
- Development of a coarse resting hand tremor, diaphoresis, and new-onset hypertension in a hospitalized patient on post-operative day three.Alcohol withdrawal syndrome
Cevap
The clinical presentations map to the following syndromes: rhinorrhea, yawning, and piloerection indicate opioid withdrawal; diaphoresis, mydriasis, and pressured speech indicate stimulant intoxication; rotary nystagmus and analgesia indicate PCP intoxication; and post-operative tremor with hypertension indicates alcohol withdrawal.
Each syndrome is identifiable by unique hallmark features. Opioid withdrawal is defined by flu-like symptoms, yawning, and piloerection. Stimulant intoxication presents with generalized sympathetic overactivation, prominently featuring mydriasis and psychomotor agitation. PCP intoxication is virtually unique in causing rotary nystagmus coupled with extreme analgesia. Finally, unexpected alcohol withdrawal in hospitalized patients classically emerges 2 to 3 days after admission with a coarse tremor and autonomic instability.
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Anahtar Kavram
Clinical diagnosis of substance-induced toxidromes and withdrawal syndromes