On physical exam vital signs are normal except for a slight tachycardia at 100/min during agitation, she is well perfused and hydrated, apyretic. No alcoholic foetor. Cardio-pulmonary exam is normal, as is the digestive system. Neurologic exam shows the behaviour mentioned above, a slight mydriasis on both sides, with a good reactivity to light but is otherwise normal: no sensitive or motor deficit, patellar and radial reflexes are normal, no plantar skin reflex, no dysmetria nor coordination problems. Walk and balance were not tested.
Her aggressiveness increased after examination, she tried to hit and bite the staff at many occasions, security was called and she had to be physically restrained and injected twice with 5mg of Olanzapine intramuscular. After that, a peripheral line was put in place and lab were sent.