Question 1

You are covering the acute medical ward at night.

The nurse in charge has asked you to review Emma, a 31-year-old woman who was admitted earlier in the evening with an acute psychotic episode. Emma was highly agitated at this time, and was given multiple intramuscular injections of haloperidol.

Since, Emma has deteriorated. She has become very disoriented, and is unable to move her limbs. Her temperature is 40.5°C. The urine in her bedpan is a strange colour.

While treating Emma, you request some blood tests and a urine dip. The results of the urine dip are shown below:

What is the most likely cause of Emma's abnormal urine dip?