Tweet
Hi gang... decided to make this thread at the suggestion of Barakzaiabdali... This is primarily for those members who are in healthcare but please feel free to join in if you have something useful to add 
perhaps we can learn from each other etc,,,
so basically thought that here we could do case based discussions and talk about interesting cases
I saw a good one the other day
65 year old lady admitted with SOB and productive cough... Known COPD patient and she was commenced on antibiotics plus oral prednisalone 30mg. A few days later the nurses became increasingly concerned that the patient had for the previous 36 hours or so become increasingly confused and had started hallucinating. I was called to see the patient and did my normal approach... checked the bloods... apart from an elevated WCC and a slightly decreased Potassium there was nothing nill of note... I checked the urine analysis and it was NAD. The patient was not septic and with regards to her chest it was getting better... The patient at this point was hallucinating and thought she was seeing tigers on the ward and that the nurses were trying to kill her.... It then clicked why she was she was... she was on the prednisalone! This was a clear case of Steroid induced Psychosis!
my plan was to stop the Prednisalone and my consulatant agreed with me that i had got the diagnoses right
perhaps we can learn from each other etc,,,
so basically thought that here we could do case based discussions and talk about interesting cases
I saw a good one the other day
65 year old lady admitted with SOB and productive cough... Known COPD patient and she was commenced on antibiotics plus oral prednisalone 30mg. A few days later the nurses became increasingly concerned that the patient had for the previous 36 hours or so become increasingly confused and had started hallucinating. I was called to see the patient and did my normal approach... checked the bloods... apart from an elevated WCC and a slightly decreased Potassium there was nothing nill of note... I checked the urine analysis and it was NAD. The patient was not septic and with regards to her chest it was getting better... The patient at this point was hallucinating and thought she was seeing tigers on the ward and that the nurses were trying to kill her.... It then clicked why she was she was... she was on the prednisalone! This was a clear case of Steroid induced Psychosis!
my plan was to stop the Prednisalone and my consulatant agreed with me that i had got the diagnoses right
