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MDMA-associated hyponatremia and hyperthermia — ABEM Board MCQ

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HardToxicologyMDMA-associated hyponatremia and hyperthermiaABEM Board

A 24-year-old man arrives as ESI 2 after taking MDMA at a club. Temperature is 40.3 C, HR 148, BP 164/88. Sodium is 118 mEq/L and he has a seizure. Which of the following is the most important immediate intervention?

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Correct answer: C — Administer hypertonic saline and active cooling

MDMA can cause severe hyponatremia and hyperthermia; seizure with Na 118 requires hypertonic saline plus cooling.

Reference: Goldfrank Toxicologic Emergencies; hyponatremia guidelines