Which of the following opioids did the patient most likely take?

Correct Answer: D

Rationale: The patient self-injected what he believed to be heroin, which is commonly sold on the street. Fentanyl is a potent synthetic opioid that is often mixed with or sold as heroin due to its powerful effects. Therefore, the patient most likely took Fentanyl, as it is frequently associated with street drugs like heroin.

Correct Answer: D

Rationale: Meperidine is a commonly used opioid analgesic that is often used in detoxification programs due to its ability to help manage withdrawal symptoms. In this case, the patient was undergoing a detoxification program supervised by surgery, and a drug was administered intravenously. Meperidine is a likely choice as it can help alleviate withdrawal symptoms and manage pain during the detoxification process.

Correct Answer: B

Rationale: The symptoms described in the scenario, such as elevated mood, rapid speech, muscle twitching, and dilated pupils, are consistent with the effects of marijuana use. Increased heart rate is a common physiological response to smoking marijuana due to the drug's impact on the cardiovascular system. Additionally, euphoria and uncontrollable laughter are typical psychological effects of marijuana use, further supporting the choice of increased heart rate as the correct answer.

Correct Answer: D

Rationale: The patient's signs and symptoms, such as mydriasis, tonic-clonic seizure, shallow respiration, and cardiovascular collapse leading to death, are consistent with LSD intoxication. LSD is known to cause agitation, altered mental status, and severe physiological effects, making it the most likely cause of the patient's death.

Correct Answer: D

Rationale: The signs and symptoms described in the text, such as talkativeness, mydriasis, muscle twitching, hand tremor, elevated blood pressure, and increased heart rate, are consistent with the effects of amphetamine use. Amphetamine is a stimulant drug that can cause these symptoms by increasing the release of neurotransmitters like dopamine and norepinephrine in the brain. Additionally, the patient being a drug user who tried different drugs supports the likelihood of amphetamine use, as it is commonly abused for its stimulant effects.