A 60-year-old woman presents to the ED with severe epistaxis. She is on Coumadin for atrial fibrillation and has recently been in the hospital for an unspecified illness. On examination, she has stable vital signs and, other than some dried blood in her nares, has no other signs of a bleeding diathesis. Her INR is 1.0. It was 2.2 at discharge. Which of the following other medications, if given to the patient on discharge, could be responsible for the sudden change in her INR?

A 25-year-old male is brought in by ambulance after a tonic-clonic seizure that was witnessed by his roommates. The patient is obtunded with a blood pressure of 70/30 mmHg and a heart rate of 110 beats per minute. Lungs are clear, heart sounds are normal, and bowel sounds are diminished. Pupils are 5-6 mm and equal, although minimally reactive. The patient's skin appears slightly reddened diffusely and is warm and dry to the touch. An electrocardiogram reveals a wide-complex tachycardia with a QRS of 110 ms. The roommates offer an empty prescription bottle and say the patient was "given these by his therapist for depression." The patient is quickly intubated and two intravenous lines with normal saline are started just as the patient has another seizure, which is quickly controlled with 2 mg of IV Ativan. Which of the following options is the next MOST appropriate intervention? 

Parents of a 35-year-old woman bring their daughter to the ED. She has recently been diagnosed with the flu and has been taking over-the-counter cold medicine for the last 3 days. Last night, according to them, she began behaving differently, acting confused and agitated. Her parents also noticed that she was shaking all the time. She began having diarrhea this morning. Her past medical history is significant only for depression, and her psychiatrist has recently added a low dose of trazodone to her daily Paxil. On examination, the patient is mildly agitated and anxious but consolable. Her vital signs are as follows: pulse 105 beats per minute, blood pressure 160/95 mmHg, respirations 21 per minute, and temperature 40°C rectally. She has a normal heart and lung examination except for tachycardia, and there are no skin rashes. Examination of the oropharynx reveals prominent salivation but no other abnormalities. She does exhibit some mild rigidity of the muscles of the lower extremities along with diffuse shivering; reflexes are 3+ and equal. There are 3-4 beats of clonus present with plantar reflex examination. Based on this history and physical examination, which of the following is the MOST appropriate treatment for this patient?

Which statement about monoamine oxidase inhibitor (MAOI) overdose is TRUE? 

Which of the following side effects of neuroleptic medications is paired INCORRECTLY with its clinical presentation?