Patient is a 47-year-old female presenting to the emergency department due to shaking, altered mental status, and nausea/vomiting. She has a past medical history of bipolar disorder. Family member at bedside states that she was vomiting 2 days ago and took 15-20 extra of her bipolar medication as the patient was concerned she had vomited up all of her medication. Her nausea and vomiting has continued to worsen over the next few days. On examination patient has hypereflexia, slurred speech, confusion and muscle twitching. Blood work is significant for a Creatinine: 1.96, WBC: 17.0 and a negative UDS.
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Author: Sarah Rubin, PGY4 EM
Residency: Jefferson Northeast
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