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Delirium — MCCQE Part 1 MCQ

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EasyDeliriumDeliriumMCCQE Part 1

A 70-year-old man is acutely confused, agitated, seeing things not there. Well yesterday. Had urinary catheter placed 3 days ago post-surgery. On oxycodone. Most likely diagnosis?

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Correct answer: B — Delirium

Acute onset + fluctuating confusion + identifiable precipitants (surgery, catheter/UTI, opioid) = delirium. Key distinction from dementia: acute onset and fluctuating course. Treat underlying cause. Avoid benzos (worsen delirium except in ETOH withdrawal).

Reference: Canadian Geriatric Society Delirium Guidelines