ChoiceHub
Sign in
A 77-year-old woman is brought to the emergency department by her daughter because she has become confused and unsteady over three days. Five weeks ago her general practitioner started sertraline for a depressive episode; she takes no other medicines. She is afebrile and drowsy but rousable, with normal pupils, moist skin, audible bowel sounds and normal tone; there is no tremor, clonus or rigidity. Blood glucose is 6.1 mmol/L, sodium 118 mmol/L (135-145), potassium 4.0 mmol/L (3.5-5.2), creatinine 61 micromol/L (45-90) and creatine kinase 90 U/L (30-150). Which one of the following best accounts for her confusion?
Shared by Mornienmiddle twist

Keep going — a set of ten like this one, one at a time.

Practise more

More from Psychiatry

See all

A 34-year-old man who came to Australia from Somalia six years ago is reviewed by his general practitioner for a depressive episode. After eight weeks of sertra…

Pre-internship · niche

A 40-year-old man who came to Australia from Iraq as a refugee eight years ago attends a general practice with six months of broken sleep, nightmares and daily…

Clinical rotations · middle twist

A 71-year-old woman who migrated from Hong Kong 40 years ago is admitted to a psychiatric ward with a severe depressive episode. She speaks Cantonese and almost…

Pre-internship · middle twist

A metropolitan mental health service is examining why Aboriginal and Torres Strait Islander inpatients leave the ward against medical advice far more often than…

Clinical rotations · middle twist

A 52-year-old man born in Vietnam, who has had schizophrenia for 25 years, comes to an emergency department with six hours of epigastric pain. He speaks limited…

Pre-internship · niche