Altered Mental Status 277269.A 54-year-old man is brought to the ED by his wife for bizarre behavior.
The wife complains that her husband has not been acting like his usual self
over the last several days. She states that he has not had any change in sleep,
appetite, or activity level. She also recalls that her husband complained of
morning headaches for the last 2 months. The patient is otherwise in good
health and does not take any medications. His BP is 135/87 mm Hg, HR is
76 beats per minute, temperature is 98.9°F, and RR is 14 breaths per minute.
His examination is otherwise unremarkable. Which of the following is the
most likely diagnosis?
a. Migraine headache
b. Tension headache
c. Subarachnoid hemorrhage
d. Pseudotumor cerebri
e. Frontal lobe mass
270.A 27-year-old woman is brought to the ED by her husband after hav-
ing a first-time seizure at home. She has no past medical history, and had
no complications while delivering her newborn vaginally 1 week prior to
presentation. In the ED, her BP is 178/95 mm Hg, HR is 97 beats per
minute, temperature is 99.1°F, and RR is 18 breaths per minute. On exam-
ination, she has mild edema of her hands and feet. The seizure stopped
spontaneously, but the patient is postictal appearing and cannot answer your
questions. Which of the following is the most appropriate diagnostic test?
a. Complete blood count
b. Head CT
c. LP
d. Urinalysis
e. ECG