Question

Mikey is a 5 year-old boy brought to the Emergency Department by his parents with an initial complaint of a ~24 hour recent history of odd behavior consisting of confusion, delusions & inappropriate laughter. A physical exam reveals that Mikey has a fever, elevated heart rate, dilated pupils, blurry vision, and an unusual pink flush color on his skin. His blood pressure is relatively normal. His parents mention that Mikey has seemed unusually thirsty, and has been drinking a large amount of water & Koolaid over the past 12 hours. Upon further questioning, Mikey mentions that he recently consumed some berries growing on a shrub in a post-Katrina abondoned lot near his home. Some left over berries from his pants pocket are shown below. Based upon Mikey's symptoms, the active ingredient(s) in these berries have properties similar to:

A. Atropine
B. Pilocarpine
C. Reserpine
D. Physostigmine
E. Tyramine

Answer 1

Mikey's symptoms suggest he has ingested berries containing atropine, a substance that causes anticholinergic symptoms by suppressing the parasympathetic nervous system.

Step-by-step explanation:

Based on the symptoms described for Mikey, such as confusion, delusions, inappropriate laughter, fever, elevated heart rate, dilated pupils, blurry vision, and unusual skin flush, the active ingredient in the berries he consumed seems to have properties similar to atropine. Atropine is known to cause anticholinergic symptoms like those Mikey is experiencing. His symptoms reflect the suppression of the parasympathetic nervous system, which is consistent with atropine or scopolamine poisoning. These substances are found in certain toxic plants, such as the Atropa belladonna, also known as deadly nightshade. Moreover, Mikey's increased thirst and the consumption of a large amount of water could be in response to the dry mouth caused by atropine-like substances.