Movement Disorders USMLE Step 1 Practice Question
A 49-year-old man with Parkinson disease controlled on selegiline presents with fever (38.9°C), agitation, diarrhea, and inducible ankle clonus after starting sertraline for depression. Vital signs show tachycardia (102 bpm) and tachypnea (20 breaths/min). Laboratory studies reveal elevated creatine kinase (1,200 U/L). He denies recent infections or medication non-adherence. Which of the following best explains this drug interaction?
Answer choices
- AWilson disease unmasked by serotonergic therapy
- BSerotonin syndrome precipitated by MAO-B inhibition and SSRI useCorrect answer
- CAcute dystonia due to D2 blockade in the nigrostriatal pathway
- DNeuroleptic malignant syndrome due to dopamine depletion
- ECombined cholinergic toxicity due to muscarinic excess
- FAnticholinergic crisis due to excessive cholinergic blockade from sertraline metabolites
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