A elderly patient collapses in hot weather with heat-related symptoms. Which manifestation would NOT typically be expected in heat stroke?

A elderly patient collapses in hot weather with heat-related symptoms. Which manifestation would NOT typically be expected in heat stroke?

• A. Muscle cramps
• B. Seizures
• C. Hot, dry skin
• D. Disorientation and confusion

Answer: (A)

Heat stroke is defined by a very high core temperature with central nervous system dysfunction. In the classic, elderly presentation, the skin is hot and dry because sweating has waned, and neurologic signs like disorientation or seizures are common. Muscle cramps, however, stem from electrolyte losses during sweating and are typically seen with heat cramps or heat exhaustion, not as a defining feature of heat stroke. So the finding not expected with heat stroke is muscle cramps.

Heat stroke is defined by a very high core temperature with central nervous system dysfunction. In the classic, elderly presentation, the skin is hot and dry because sweating has waned, and neurologic signs like disorientation or seizures are common. Muscle cramps, however, stem from electrolyte losses during sweating and are typically seen with heat cramps or heat exhaustion, not as a defining feature of heat stroke. So the finding not expected with heat stroke is muscle cramps.