A 78-year-old woman is brought in by her son. He is

concerned about her agitation. On examination, you note she is agitated and

appears confused about the date and time. She has a low grade fever and her

urinalysis is suggestive of a urinary tract infection. She is now physically

aggressive towards her son at the bedside and he is extremely distressed as she

starts hitting the nurse tending to her.

Which of the following treatment is the most appropriate

medication to manage her agitation?

A 35 year old patient is sent home with his first episode of

severe gout of hit first MTP joint on the right foot. He filled his

prescription at the local chemist. He returns 5 days later with his wife due to

aggression, irritability and insomnia. His wife tells you he has bipolar disorder which has been well controlled for a long time. She has never seen him like

this before.

You think it might be due to the medications he was sent

home with for his gout.

Which of the following medication is likely to be the cause?

A 35 year-old-man with known polysubstance abuse presents

with agitation and paranoid ideations. In the ED last night, it was noted that

he appears to be responding to internal stimuli - auditory and visual hallucinations. He is

reviewed this morning after a 14-hour admission to the 24 hour observation ED

ward. He has complete resolution of his symptoms and is apologetic for his

behaviour last night. He has no recollection of the events.

Which of the following is the most likely cause of his

behaviour?

You are asked by the nurse to attend to an angry patient at

Triage. The patient is sitting at Triage and you introduce yourself as the

doctor. He appears to be extremely angry about the long wait. He is calm and

not physically aggressive.

Which of the following is the most appropriate first step in

your interaction with this patient?

An 86-year-old is brought in by her daughter due to a week

history of confusion and inability to manage at home.  She has been living independently for the

last 12 months since being widowed, but in the last week there have been times where she has not remembered to take her medications or eat meals at the right time.  She was seen by the GP but at that point seemed reasonably good and the GP didn't think there was anything to worry about. Her daughter has no confidence in the GP

and hence brought her into the ED.

Which of the following in the history is suggestive of

delirium and not dementia?

A 22 -year-old man is brought in by police. He is physically

aggressive and has been restrained with handcuffs. In the ED, he continues to

be combative. Verbal de-escalation has been unsuccessful.

Which of the following is the most appropriate management?

A mother of 2 presents to the ED with insomnia and

restlessness. Her HR is 105/min, BP 124/80 RR 20/min Temp 37.8C. She tells you

she is so restless that she cannot work and cannot look after her children.

Which of the following is the most appropriate next step in

your management in the ED?