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Brief pathophysiology of patient in scared-agitated state


Case Scenario: A 20-year-old man is brought to the emergency department (ED) by his friends in a scared and agitated state. He had been playing basketball several hours ago with his friends when he suddenly began complaining of being stung by bees. He began behaving erratically and saying that bees were coming out of his ears and mouth. He began accusing one of his friends of plotting against him and blaming him for his condition. He became agitated and ran away from the basketball court, darting in and out of traffic on the adjoining street. His friends had to track him down and force him to come to the hospital. His friends report that some of them had been smoking "weed" prior to the game, and the patient was a "newbie to weed." His friends do not believe he has had any psychiatric problems in the past but cannot be sure. On examination, the patient appears anxious, apprehensive, and fearful. He looks around the room furtively, repeatedly spitting into a cup. He is fully aware of his surroundings, but his attention span is very short. His memory is intact and fully oriented. He no longer suspects his friend and holds out the cup he has been spitting into for the doctor to inspect for bees. He finds it unbelievable that he has bees crawling out of himself but cannot help feeling the sensation. Physical examination reveals redness of eyes and an elevated pulse rate. Otherwise, the physical examination is normal. Neurologic examination is within normal limits. The patient complains of the bees "sucking out all [his] energy making [him] very hungry."

Questions:

1. Brief Pathophysiology of the case. Need Assignment Help?

2. Differential diagnoses (at least three)

3. Recommended diagnostic test or any screening tool (if indicated)

4. Final/Working Diagnosis based on current DSM criteria

5. Treatment plan: include pharmacotherapy and psychotherapy or both as appropriate.

6. Any cultural, ethical, or legal consideration (if applicable)

7. Client education

8. Recommend any other services/consultation as appropriate.

9. Follow-up plan.

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Other Subject: Brief pathophysiology of patient in scared-agitated state
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