Author: Nauman Arshad / Editor: Yasmin Sultan / Codes: ELP1, GP1, MHP1, MuC4, NeuP2, OncC3, SLO1, SLO3, SuP1, UP5Published: 01/03/2023

A 47-year-old female patient present to Emergency Department (ED) with 15 days history of headache, lethargy severe right groin pain and feeling tired all the time. She remembered hearing voices (Hallucinations). She also complains of on and off right loin to groin pain in last 2 weeks. She is feeling nauseous most of time and had constipation which got worse in last 3 weeks.

She had past medical history of gallstones and depression. She stopped taking Citalopram three weeks ago. She is on hormone replacement therapy.

Examination:

  • Blood pressure: 200/111 mmHg.
  • Pulse: 86 regular.
  • Oxygen saturation is 99% on room air.
  • Respiratory rate is 22 breaths/min.
  • Temperature: 36.6 C.
  • GCS (Glasgow Coma Scale) is 15/15.

Her AMT (Abbreviated mental test) score is 10/10.

She is alert and oriented; however, she was slow in answering questions. Her Pelvis and right hip X-Ray did not show any bony injury.

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