For the same patient, what investigations are needed for the assessment of her paracetamol poisoning?

Choose all the appropriate investigations (more than one answer).

A 16-year-old girl with a history of ADHD is brought to ED by her parents. She is

agitated, restless and complains of palpitation. HR 140 bpm, BP 180/100 mm Hg,

pupils 7 mm. She is hyper-reflexic and looks very anxious. ECG shows sinus tachycardia.

When questioned, she says she has been taking more lisdexamphetamine to help her to perform well in her examinations.

Question:

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?