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Neuroleptic malignant syndrome — SCE Acute Medicine MCQ

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ModerateToxicology and OverdoseNeuroleptic malignant syndromeSCE Acute Medicine

A 45-year-old man is assessed on the acute medical unit. He recently started haloperidol and presents with fever, confusion and generalised rigidity. Creatine kinase is 8,000 IU/L. Initial assessment includes relevant observations, bedside tests and urgent blood results. What is the most likely diagnosis?

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Correct answer: B — Neuroleptic malignant syndrome

Neuroleptic malignant syndrome is the best answer because fever, rigidity and rhabdomyolysis after dopamine antagonist exposure suggest neuroleptic malignant syndrome. Organophosphate poisoning is plausible, but it is less appropriate for the physiology or timing described in this stem. The other distractors either fit a neighbouring presentation, delay definitive treatment, or miss the key immediate risk. Clinical pearl: Stopping the causative drug and supportive care are central.

Reference: BNF; NICE CKS