History A 20-year-old woman has been brought to the emergency department by her friends from the local nightclub. She is agitated, confused and verbally aggressive. The friends report a fitting episode lasting 30 seconds en route to the hospital. They also say that she has taken ‘some pills’. She refuses to cooperate with staff and says she wants to dance.
Examination She will not agree to a full examination, but cooperates enough for observations to be obtained: temperature 38°C, heart rate 130/min (regular), blood pressure 170/130 mmHg, SaO2 99 percent on room air. She is noted to have excessive diaphoresis and has grossly dilated pupils (size 5). She is very talkative and paces up and down the department. What are the differential diagnoses of this woman’s presentation? *This case is from Docplexus editorial team for educative purpose only Source: 100 clinical cases in acute medicine…
