SAQ Stack

1. Other than reduced conscious state, list clinical signs you would seek on physical examination that are associated with GHB toxicity. 2 marks

2. List benefits and risks regarding the utility of intubation in the management of this patient. 4 marks

3. List important non-toxicological differential diagnoses for altered conscious state that would require specific treatment (other than supportive care), and for each, give your method of confirming the diagnosis if suspected. 3 marks

The patient wakes up a couple of hours later after a period of observation and supportive care. He admits to using GHB ‘not infrequently’ but is declining D+A input at this time

4. Give risk factors which predisposed GHB users to delirium/severe withdrawal. 3 marks