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You are seeing a 17-year-old boy who presents with agitation and confusion. He arrived home after “hanging out with friends” and didn’t seem right to his parents, who brought him to the Emergency Department. On exam, his vital signs are: HR 115, BP 142/88, RR 18, Temp 37.6, and pulse ox 98% on room air. On exam, he has dilated pupils, tacky mucous membranes, and flushed skin.
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December 31, 2025 at 12:19 pm
I cannot remember how to find out the actual answer to the questions….
January 1, 2026 at 12:28 am
I usually post the answer here in comments 1-2 days after the question comes out.
January 1, 2026 at 12:26 am
A) Ecstasy
Ecstasy is a sympathomimetic whereas the other agents listed cause an anticholinergic toxidrome. The mnemonic for the anticholinergic toxidrome are: Mad as a hatter (confusion, hallucinations), Red as a beet (flushing), Hot as a hare (hyperthermia), Dry as a bone (no sweating, dry skin and dry mucous membranes), Full as a Flask (urinary retention). Sympathomimetics and anti-cholinergics both cause tachycardia, mydriasis, and hyperthermia but the lack of sweating differentiates the anticholinergic toxidrome from sympathomimetic.