A 24-Year-Old Man Is Brought to the Emergency Department by Police

A 24-year-old man is brought to the emergency department by police and emergency medical services personnel due to aggressive behavior toward his girlfriend.  She reports that he has no history of medical or psychiatric illness and that this behavior is new.  During transport, the patient was combative and difficult to restrain.  He currently appears agitated, disoriented, and confused and seems to be responding to internal stimuli.  Temperature is 37.2 C (99 F) , blood pressure is 170/96 mm Hg, pulse is 118/min, and respirations are 20/min.  Nystagmus and ataxia are present on initial neurologic examination.  The patient does not cooperate with urine toxicology testing.  His symptoms begin to resolve after 8 hours in the emergency department.  He has very poor recollection of the previous night's events.  Which of the following substances is most likely causing the constellation of symptoms seen in this patient?

A) Cocaine
B) Diazepam
C) Heroin
D) Lysergic acid diethylamide
E) Methamphetamine
F) Phencyclidine
G) Tetrahydrocannabinol

Correct Answer:

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