Heating: It’s Not Just the Bills Giving You a Headache

Give three differential diagnoses for this lady’s symptoms.

Further collateral history reveals she has been to see her GP several times with general lethargy, headaches and feeling irritable with poor concentration.

Her husband tells you they have recently moved here and that she stays at home to look after their son, age 3. She has just been started on citalopram by her GP, is on no other medications, is a non-smoker and drinks a glass of wine or two most evenings.

He also tells you he has been worried about their son who is always a happy, engaging child when at friends’ houses or playschool, but at home becomes subdued, withdrawn and irritable.

What further investigations would you do if you suspect carbon monoxide poisoning?

Carbon monoxide level comes back as 5%.

Give two immediate management steps and what complications might occur in this patient?