Hey folks, just a quick reminder that this podcast is not meant to be used for medical

advice, just good old-fashioned education, and all patient information has been modified to

protect their identity.

Hi folks, welcome to the clinical problem solvers.

My name is Robbie Gija and my co-host is Reza Manesh. Reza, how are you doing? I'm feeling pretty great. Just had some Chick-fil-A and I'm in a post-pranadio coma ready to present a case to you. How are you feeling, Robbie? Oh, that sounds awesome, Rez. I, unfortunately, I'm on a little bit of a downer. I lost another game of ping pong to my 82-year-old friend. Yes, he's actually 82, and he plays ping pong. It's incredible. But I am really psyched for our first episode. We also have Charmina Arslan here as well. Can I just say something? I said I'm in a post-pranjero coma ready to present to you.

And you said, that's awesome. And that's going to make the final cut, Robbie. Oh, of course it is. What's wrong with the post-pranial coma? I don't get it. That's awesome. That's like the best feeling in the world. If I'm ever down, I just need to go around you, Robbie. You always make me feel good.

If it's post-Prandial, it'll go away.

That's a fair point. Robbie, I'm feeling really good too, except I work out maybe once a month, and that happened a couple days ago, and my arms have been just killing me since. Charming, how are you doing? I'm doing good, super excited for this

episode. And Robbie, hey, if you ever want to feel better about your ping pong skills, we can play

with each other. I'm really, really good at hitting the shadow of the ball, so I think your chances

are really good. My mom told me that I should just play with my hand.

I don't know. I think it's going to be tough, my friend.

That's great.

All right, Raz, why don't you take us away?

Yes, sir.

So, Ms. S is an 82-year-old woman who presents with acute onset of confusion and agitation.

Miss S's daughter reports that her mother has had intermittent episodes of confusion and disorientation. However, during these episodes, she's maintained the ability

to recognize her family and was redirectable. However, yesterday afternoon, after being awoken

from a nap, she was acutely altered, confused, and combative.

She had never had an episode like this. Her daughter became concerned and brought Ms. S to the

hospital. Well, first of all, I'd be combative if you ever woke me up from a nap,

especially a post-pranial coma. That would be horrible. But let's establish

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