每日一题_2023.09.23

A 20-year-old man became very agitated at a party, and as a result was brought to the emergency department. In the waiting room he is belligerent and uncooperative. A physical examination reveals fever, tachycardia, horizontal nystagmus, hyperacusis, and pupils that are 3 mm in diameter bilaterally. Which of the following substances is most likely causing the behavioral changes and physical findings exhibited by this patient?

一名20岁的男子在一次聚会上非常激动，结果被送进了急诊科。在等候室里，他好斗，不合作。体格检查显示发热、心动过速、水平眼震、听觉过敏和双侧瞳孔直径为3 mm。下列哪一种物质最有可能引起该患者表现出的行为改变和身体表现?

(A) Alcohol酒精

(B) Amphetamines安非他命

(C) Cocaine可卡因

(D) Lysergic acid diethylamide 麦角酸二乙胺

(E) Nicotine尼古丁

(F) Phencyclidine苯环己哌啶

答案解析：

该患者服用了苯环己哌啶（一种麻醉药和致幻剂）。PCP中毒患者表现出好战、冲动、发热、精神运动性激越、垂直和水平眼震、心动过速、共济失调、杀人、精神病和谵妄的迹象。停药时，当PCP以电离形式滞留在酸性胃腔内，在碱性十二指肠被重吸收时，患者可能表现出中毒的复发。PCP使用者瞳孔正常或较小。多种原因可导致死亡，包括呼吸抑制和暴力行为。

正确答案：F