Case 1

A 23-year-old man is brought in by ambulance, with the assistance of the Gardai, after being found behaving strangely by a passer-by on the street. He is extremely agitated and is verbally and physically aggressive toward staff.

Vital signs are unrecordable, though he is noted to be moving all four limbs, is diaphoretic and his pupils appear dilated. His past medical history is unknown as he has not given his name or date of birth

Question 1

What is your differential diagnosis for his abnormal behaviour?

Question 2

How would you immediately manage the situation and what important actions must be considered following initial management?

Question 3

What important investigations should be carried out?

Question 4

Depending on aetiology of his behaviour, what would be the disposition of this patient?