14th June 2021

A 25-year-old man is brought to A&E by the police (2)

A 25-year-old man is brought to A&E by the police. They had attended a scene at a shopping centre, where he was found to be being aggressive to members of the public whilst promoting what he called his “life-changing knowledge of the world” using a megaphone. He reportedly struck a man who had laughed at him.

On assessment, he is disorientated to time, place and person, and talking incredibly quickly in a rambling and nonsensical manner. His observations are within normal ranges, other than a low-grade temperature of 37.9, and his peripheries are warm and flushed. There are no obvious signs of infection on examination, although his compliance is variable. He agrees to blood tests, with samples being taken for a FBC, U&Es, LFTs, TFTs and a calcium profile.

His mother attends the department and reports that his behaviour has been increasingly unstable over the past week, and she does not think he has slept for several days. 

Which THREE additional investigations should be performed at this initial assessment?  Select THREE options only.