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Mary Nguyen, a 64-year-old self-proclaimed master gardener, was walking to her garden where she was planning to spend the rest of the afternoon. Mary has

December 3, 2024

Mary Nguyen, a 64-year-old self-proclaimed master gardener, was walking to her garden where she was planning to spend the rest of the afternoon. Mary has been checking on her strawberries every day, to ensure they don’t end up like last year’s harvest. Insect food.

This morning, Mary met up with her walking club, as she has done every morning for the past 3 years. After walking about half a mile, Mary began wheezing severely, and was promptly taken to the emergency room.

You, a bright-eyed and bushy-tailed Emergency Nurse, were asked to take Mary’s vitals and patient history. Mary’s heart rate is 13 beats/15 seconds; blood pressure is 80/56 mmHg; and temperature of 98.4°F. You also note that the patient’s pupils are dilated, she has a decreased patellar reflex, and sialorrhea is present. The patient complains of nausea, headache, abdominal cramps, muscle twitches, and increased salivation.

You begin to ask Mary as series of questions and she is able to tell you the following between gasps of air. “Last week, I was complaining to my best friend Bonnie Thomas, a local dairy farmer, that every year my strawberries get ravaged by those tiny devils. Bonnie was very sympathetic as she too lost many harvests, decided to try to help me. I don’t recall the name of the product I received from Bonnie, but it is definitely a jug of super strength insect killer. When asked, she does admit she has been using this product every day, and notes that the product “has an odd but sweet, pleasant smell, that reminds her of her childhood”.4) Presume Mary was not taken to the emergency room. Hypothesize various outcomes that could have occurred if left untreated.

Questions

5) Caffeine, if taken in high quantities, acts as an acetylcholinesterase inhibitor. What might have happened to Mary if she ingested a large quantity of caffeine?

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