Bipolar Disorder (Mania)

Clinical Pathology > Neurology & Psychiatry > Psychiatric Disorders

Q. A 78 year-old patient is noted to have a fairly sudden change in mentation and goes from being alert, interactive, and aware of world-events to being somnolent with intermittent hyperarousal, having hallucinations, disorientation, and abnormal thought processes. Which of the following is the best course of action?

This patient has abrupt-onset dementia. Start donepezil after ruling-out subdural hematoma.

This patient has abrupt-onset dementia. Determine code status and patient's wishes before the patient is no longer to make this determination on their own.

This patient has delirium. Give the patient an antipsychotic emergently to reverse the condition before waiting on laboratory testing.

This patient has delirium. Check for any identifiable cause such as urinary tract infection, pneumonia, or other toxic/metabolic cause before starting empiric antipsychotic medication.

This patient has clear-cut Korsakoff syndrome. Give thiamine IV emergently.

This patient has clear-cut Korsakoff syndrome. Assess for mammillary body degeneration to confirm the diagnosis.

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