CAM — MRCPsych Paper B MCQ
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Correct answer: A — CAM
The correct answer is A, the Confusion Assessment Method (CAM). Its diagnostic algorithm requires acute onset and a fluctuating course together with inattention, plus either disorganised thinking or an altered level of consciousness. The MMSE, MoCA, AMTS and ACE-III primarily assess cognitive impairment; they do not apply this delirium-specific algorithm and cannot by themselves distinguish delirium from dementia. Although the algorithm remains characteristic of CAM, the original teaching statement is no longer an accurate summary of current NICE practice: NICE now recommends the 4AT for assessment when delirium indicators are present in general hospital or long-term-care settings, and CAM-ICU or ICDSC in critical care or postoperative recovery. The question therefore tests recognition of the CAM algorithm rather than the currently preferred general bedside assessment tool.
Reference: NICE, Delirium: prevention, diagnosis and management in hospital and long-term care (CG103), full guideline appendices, Table I1: validated instruments for delirium, 2010; guideline updated 2023. https://www.nice.org.uk/guidance/cg103/evidence/full-guideline-appendices-ac-and-hj-134653070