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Opioid overdose — USMLE Step 2 CK MCQ

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ModerateEmergency MedicineOpioid overdoseUSMLE Step 2 CK

A 58-year-old White man comes to the hospital because of progressive symptoms. History and focused examination are notable for respiratory depression, miosis, and altered mental status after injection drug use. Temperature is 98.6°F (37.0°C), blood pressure is 126/78 mmHg, pulse is 84/min, respirations are 16/min, and oxygen saturation is 98% on room air. Physical examination confirms the key finding and shows no unrelated abnormality that would better explain the presentation. Focused laboratory studies and initial testing support the clinical pattern described in the stem. Which of the following is the most appropriate next step in management?

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Correct answer: C — Naloxone with ventilatory support

The vignette describes Opioid overdose, supported by respiratory depression, miosis, and altered mental status after injection drug use. Naloxone with ventilatory support is the single best answer because it matches the diagnostic or management priority in this clinical setting. The other choices are plausible alternatives in related presentations, but they do not best fit the timing, findings, and guideline-directed approach described here.

Reference: American Heart Association Opioid Overdose Guidance