Case Discussion 140916Created by:
A middled age woman, with background of renal tranplanst (end stage renal failure due to polycystic kidney) on immunosupressant, hypertension, depresssion, was admitted through emergenncy departement by general practitioner referral due to the fact that she was acting strangely for the last 1 week. According to her husband, patient did has some sudden change of behaviour 1 week before. Patient would suddenly laughing or crying for around 20-30 minutes without any predisposing events. This will occur a few times a day for the pass 1 week. Patient was acting strangely as well, not herself. And patient was not aware about the reason why she was doing so. She did mentioned that her mood was quite low for the last few months. Based on this information, what will be your differential diagnois ? what are the invetsigations and management plan?