A 45-year-old woman presents with recent onset movement abnormalities. She says that she noticeably blinks, which is out of her control. She also has spasms of her neck muscles and frequent leg cramps. Past medical history is significant for ovarian cancer, currently being treated with an antineoplastic agent that disrupts microtubule function and an alkylating agent, as well as metoclopramide for nausea. Her blood pressure is 110/65 mm Hg, the respiratory rate is 17/min, the heart rate is 78/min, and the temperature is 36.7°C (98.1°F). Physical examination is within normal limits. Which of the following drugs would be the best treatment for this patient?
APhysostigmine
BBethanechol
CBenztropine
DDiazepam
EClozapine
A 24-year-old graduate student is brought to the emergency department by her boyfriend because of chest pain that started 90 minutes ago. Her boyfriend says she has been taking medication to help her study for an important exam and has not slept in several days. On examination, she is diaphoretic, agitated, and attempts to remove her IV lines and ECG leads. Her temperature is 37.6°C (99.7°F), pulse is 128/min, and blood pressure is 163/97 mmHg. Her pupils are dilated. The most appropriate next step in management is the administration of which of the following?
ALorazepam
BKetamine
CHaloperidol
DActivated charcoal
EDantrolene
A 38-year-old woman comes to the physician for a follow-up visit. She has a 2-year history of depressed mood and fatigue accompanied by early morning awakening. One week ago, she started feeling a decrease in her need for sleep and now feels rested after about 5 hours of sleep per night. She had two similar episodes that occurred 6 months ago and a year ago, respectively. She reports increased energy and libido. She has a 4-kg (8.8-lb) weight loss over the past month. She does not feel the need to eat and says she derives her energy ""from the universe"". She enjoys her work as a librarian. She started taking fluoxetine 3 months ago. On mental exam, she is alert and oriented to time and place; she is irritable. She does not have auditory or visual hallucinations. Physical examination shows no abnormalities. Which of the following is the most likely diagnosis?
ADelusional disorder
BCyclothymic disorder
CSchizoaffective disorder
DBipolar II disorder
EMedication-induced bipolar disorder
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