ICU Delirium Diagnosis — FRCA Final MCQ

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

EasyIntensive Care MedicineICU Delirium DiagnosisFRCA Final

A 45-year-old man in the ICU has new-onset confusion, agitation, inattention, and disorganised thinking on day 3 of his admission. His RASS is 0 but his CAM-ICU is positive. What is the diagnosis?

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

Reveal the answer and explanation

Correct answer: E — Inadequate sedation

A positive CAM-ICU (Confusion Assessment Method for ICU) in an alert patient (RASS 0) indicates ICU delirium. Delirium is characterised by acute onset, fluctuating course, inattention, and either disorganised thinking or altered level of consciousness. It affects up to 80% of ventilated ICU patients and is independently associated with increased mortality, prolonged ICU stay, and long-term cognitive impairment. Prevention includes minimising sedation (especially benzodiazepines), early mobilisation, sleep hygiene, and cognitive stimulation. Haloperidol or quetiapine may be used for hyperactive delirium.

Reference: ICS – 2023 – Delirium in critical care guidelines; Ely EW et al – 2001 – CAM-ICU validation