CAM — MRCPsych Paper B MCQ

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EasyLiaison PsychiatryCAMMRCPsych Paper B

Which bedside assessment instrument for delirium uses an algorithm requiring both acute onset or a fluctuating course and inattention, together with either disorganised thinking or an altered level of consciousness?

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Correct answer: D — Confusion Assessment Method (CAM)

The correct answer is **B, the Confusion Assessment Method (CAM)**. Its short algorithm requires both acute onset or fluctuating course and inattention, plus either disorganised thinking or an altered level of consciousness. The original explanation was incomplete because it omitted the fluctuating-course element and did not clearly state that the first two features are mandatory. MMSE, MoCA and ACE-III assess broader cognitive functioning and are not delirium-specific algorithms; AUDIT screens for hazardous or harmful alcohol use. In current UK practice, NICE recommends the 4AT for general hospital or long-term-care assessment and CAM-ICU or ICDSC in critical care. This question specifically tests recognition of the CAM algorithm rather than asking for NICE’s preferred first-line tool.

Reference: National Institute for Health and Care Excellence. CG103, Delirium: prevention, diagnosis and management in hospital and long-term care, full guideline appendices, Appendix I: Confusion Assessment Method; guideline last updated 18 January 2023. https://www.nice.org.uk/guidance/cg103/evidence/full-guideline-appendices-ac-and-hj-134653070