12-28-2010, 07:45 PM
The oncall physician is called to see a 46 y/o male patient because of seizures. The patient was admitted to the surgical ward 2 days ago, after emergency trauma surgery. The nurse reports that the patient was anxious, irritable and tachycardic last night. Later on, the nurse noted nausea, diarrhea, sweating and insomnia. The pt has tremors, startle response and hallucinations earlier tonight
Vitals
T 99
p133
BP 146/89
RR 22
O SAR 92%
You have already ordered physical exam
Gen: sweating, cigarette burns on hands, multiple tattoos and rings
Chest: wnl
Abdomen: hepatomegaly
neuro: tremors, confusion, delirium, clouded sensorium, evidence of peripheral neuropathy
Lets start with what can be the differential dx in this patient?
I thought of some sort of withdrawl, hypoxia, infection that could cause delirium. You guys can be more specific.
Vitals
T 99
p133
BP 146/89
RR 22
O SAR 92%
You have already ordered physical exam
Gen: sweating, cigarette burns on hands, multiple tattoos and rings
Chest: wnl
Abdomen: hepatomegaly
neuro: tremors, confusion, delirium, clouded sensorium, evidence of peripheral neuropathy
Lets start with what can be the differential dx in this patient?
I thought of some sort of withdrawl, hypoxia, infection that could cause delirium. You guys can be more specific.