A 20-year-old man is admitted to the emergency department after an automobile accident, in which his friend drove their car into a light pole. In the emergency department, the man smells strongly of alcohol, and his blood alcohol level is 300 mg/dL. However, he does not show any typical signs of intoxication. His gait is steady, his speech is clear, and he does not appear emotionally disinhibited. Which of the following is the most likely explanation for such a presentation?
a. The adrenaline generated in the patient because of the effects of the car crash has counteracted the alcohol in his system
b. A value of 300 mg/dL is below the intoxication level
c. The man has developed a tolerance to the effects of alcohol
d. There has been a laboratory error
e. The man has recently used cocaine, whose effects counteract the effects of alcohol intoxication
the answer is below…
The United States Medical Licensing Examination, or USMLE for short, is a three-part licensing examination that is required in order to receive a license to practice medicine within the United States.
The USMLE assesses a physician’s ability to apply knowledge, concepts, and principles, and to determine fundamental patient-centered skills that are important in health and disease and that constitute the basis of safe and effective patient care.Examination committees composed of medical educators and clinicians from across the United States and its territories prepare the examination materials each year.
This exam is designed by the Federation of State Medical Boards and the National Board of Medical Examiners to determine whether or not an individual understands and can apply the knowledge necessary to practice medicine safely and intelligently.
The USMLE is actually comprised of three different exams that are referred to as steps, which examine the individual’s knowledge of specific topics related to the field of medicine such as basic science, medical knowledge, medical skills, clinical science, and the application of all of these skills and areas of knowledge in the medical field.
All three steps of the USMLE include a series of computerized multiple-choice questions, but the format of the exam and the information covered in each multiple-choice section is different for each step of the USMLE. The USMLE Step II also has a clinical skills portion that examines an individual’s ability to work with real patients and the USMLE Step III has a computerized patient simulation portion in addition to the multiple-choice section of the exam. In order for an individual to receive a license to practice medicine, the individual must pass all three steps of the USMLE.
The correct answer is c; The man has developed a tolerance to the effects of alcohol.
After prolonged use, most drugs of abuse (and some medications) produce adaptive changes in the brain that are manifested by a markedly diminished responsiveness to the effects of the substance that has been administered over time, a phenomenon called tolerance. Anyone who does not show signs of intoxication with an alcohol level of 150 mg/dL has developed a considerable tolerance.