Case 2

A 32 y/o male is brought into the quiet room in ED by the paramedics. A passer-by called the ambulance as he was acting strangely on a busy street, attempting to hug and give money to paedestrians.

He is dressed in a bright yellow jacket with red corduroys, and is loudly proclaiming the security guard is the ‘nicest man he’s every met’ while vigorously shaking his hand.

His family arrive in the department and report he has been behaving strangely for the last few weeks, talking all the time, not sleeping very much and has been giving away a lot of his belongings. He has no history of drug use as far as they are aware.

Question 1

What is this acute presentation called?

Question 2

What is your differential diagnosis?

Question 3

How would you assess the patient?

Question 4

What are your management goals in the ED?