Acute Delirium Diagnosis — SCE Palliative Medicine MCQ

Correct answer: B — Hypoactive delirium

Hypoactive delirium is frequently missed because it lacks agitation. Acute or fluctuating inattention, altered arousal and disorientation distinguish it from depression and chronic dementia. Medication toxicity, infection, urinary retention, constipation, metabolic disturbance and uncontrolled symptoms should be sought and treated when consistent with the person’s goals. Apply this conclusion only to the clinical circumstances stated, with appropriate specialist review, contraindication checks, shared decision-making and follow-up. Reassess if the physiology, treatment response or competing risk changes. The competing options would require a different haemodynamic profile, diagnosis, procedural indication or risk balance from the one described here.

Reference: Scottish Palliative Care Guidelines: delirium. https://www.rightdecisions.scot.nhs.uk/scottish-palliative-care-guidelines/symptom-control/delirium/