Approach to involuntary movements Quiz: Ace Your Exams
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A 41-year-old man is brought to the emergency department by emergency medical services for evaluation of aggressive behavior, delusions, paranoia and involuntary movements. Bystanders called 911 when the patient was seen in a public park exhibiting erratic movements and yelling about aliens chasing him. Past medical history includes depression for which he takes fluoxetine. Temperature is 37.0°C (98.6°F), pulse is 84/min, respirations are 16/min, and blood pressure is 134/86 mmHg. Examination shows a disheveled man with asynchronous writhing movements of the bilateral upper extremities and neck as well as repetitive tongue thrusting. There is no tremor. He repeats that he is being chased by aliens. Urine drug screen and serum ethanol level are negative. Which of the following factors would increase this patient’s risk for developing the most likely underlying condition?
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