skip to main content

PINCH ME Delirium Assessment — SCE Palliative Medicine MCQ

Instant feedback + full explanation. One question, done properly.

EasyPsychological & PsychiatricPINCH ME Delirium AssessmentSCE Palliative Medicine

A 74-year-old man with advanced lung cancer on morphine is admitted with acute confusion. A systematic approach to delirium assessment identifies multiple potential reversible causes. Using the mnemonic 'PINCH ME', which of the following best represents the framework for investigating reversible causes of delirium in this patient?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: B — Pain, Infection, Nutrition/Constipation, Hydration (and hypoxia), Medication, and Environment — a structured mnemonic to assess reversible causes of delirium

Explanation lettering: C = shown as A · D = shown as B · A = shown as C · E = shown as D · B = shown as E

Option D correctly encapsulates the PINCH ME mnemonic, which is used in UK palliative medicine to systematically assess reversible causes of delirium, as supported by NHS England guidelines and NICE CG103 recommending multi-factorial assessment. Options A, B, and E are overly narrow and neglect other important domains, while Option C is incorrect: delirium in cancer is often multifactorial and frequently reversible when causes are addressed.

Reference: NHS England Palliative Care Pain & Symptom Control Guidelines (NHS England, 2020); NICE Guideline CG103: Delirium: prevention, diagnosis and management (updated January 2023), https://www.nice.org.uk/guidance/cg103/chapter/Recommendations