15th February 2025

A 24-year-old woman presents with confusion and agitation.

A 24-year-old woman presents with confusion and agitation. She is accompanied by her housemate.

Her observations are: HR 111, BP 157/88, RR 24, sats 98% (room air), temperature 39℃.

Her housemate says the patient has a past medical history of heavy periods and depression, for which she has taken tranexamic acid PRN and fluoxetine regularly for over a year. They went out to a bar last night and the housemate reports seeing her drink around 15 units of alcohol and taking drugs including nitrous oxide and amphetamines.

What is the most likely diagnosis?

Select the SINGLE most appropriate option from the list below. Select ONE option only.