Rule out other organic causes including substance abuse, medication effect or other medical conditions
Consider whether acute medical condition may be exacerbating psych symptoms
Consider emergency psychiatric evaluation in addition to medical evaluation.
Point-of-care glucose
CBC
Chem 7
LFTs
ECG (for toxicology evaluation)
ASA level
Tylenol level
Urine toxicology screen/Blood toxicology screen
EtOH
Urine pregnancy/beta-hCG (if female of childbearing age)
Consider:
Ammonia (see Hepatic encephalopathy)
TSH (hypo or hyperthyroidism may mimic mental illness)
CXR (for Tb screen or rule-out delirium in older patient)
UA (for rule-out delirium in older patients)
Head CT (to rule-out ICH in patients with AMS)
Lumbar puncture (to rule-out meningitis or encephalitis)
Ammonia (see Hepatic encephalopathy)
TSH (hypo or hyperthyroidism may mimic mental illness)
CXR (for Tb screen or rule-out delirium in older patient)
UA (for rule-out delirium in older patients)
Head CT (to rule-out ICH in patients with AMS)
Lumbar puncture (to rule-out meningitis or encephalitis)
Schizophrenia
Acute psychosis
Schizophreniform disorder
Schizoaffective disorder
Bipolar disorder
Delusional disorder
Schizotypal personality disorder
Schizoid personality disorder