Question

The presenting symptoms of LAST can vary from one patient to another. However, identify the most typical progression of symptoms, as described in this text.

A) CNS excitement → CNS depression → seizures → hyperdynamic cardiac manifestations → cardiac depression
B) CNS excitement → seizures → CNS depression → hyperdynamic cardiac manifestations → cardiac depression
C) Seizures → CNS excitement → CNS depression → hyperdynamic cardiac manifestations → cardiac depression
D) Seizures → cardiac depression → hyperdynamic cardiac manifestations → CNS excitement → CNS depression
E) CNS excitement → seizures → CNS depression → cardiac depression → hyperdynamic cardiac manifestations

Answer 1

The typical progression of LAST symptoms starts with CNS excitement, then seizures, followed by CNS depression, hyperdynamic cardiac manifestations, and ending with cardiac depression.

Step-by-step explanation:

The most typical progression of symptoms for LAST (Local Anesthetic Systemic Toxicity) is CNS excitement, followed by seizures, CNS depression, hyperdynamic cardiac manifestations, and finally, cardiac depression. Therefore, the correct sequence according to the options provided is B) CNS excitement → seizures → CNS depression → hyperdynamic cardiac manifestations → cardiac depression. These stages reflect the effect of local anesthetics on the central nervous system and the cardiovascular system leading from initial excitatory symptoms to eventual depression of these systems.