A 46-Year-Old Man Undergoes an Elective Inguinal Hernia Repair

A 46-year-old man undergoes an elective inguinal hernia repair.  After induction of general anesthesia, he is noted to be pale and tachycardic.  The patient's medical history is significant for frequent headaches, hypertension, and an anxiety disorder.  His outpatient medications include lisinopril, alprazolam, and as-needed naproxen.  The patient regularly drinks a 6-pack of beer on weekends but does not use tobacco or illicit drugs.  Family history is unremarkable.  His temperature is 36.9 C (98.4 F) , blood pressure is now 250/140 mm Hg (it was 144/90 mm Hg before induction) , and pulse is 125/min.  ECG shows sinus tachycardia with no ischemic changes.  Which of the following is the most likely diagnosis?

A) Alcohol withdrawal
B) Anaphylaxis
C) Panic disorder
D) Pheochromocytoma
E) Serotonin syndrome
F) Thyroid storm

Correct Answer:

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