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Dementia delirium screen — DGM MCQ

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EasyDementiaDementia delirium screenDGM

An 84-year-old woman with dementia is suddenly shouting at night and refusing food. Her daughter says this is very different from baseline. She has suprapubic tenderness and a temperature of 38.2°C. Current medicines include donepezil and ramipril. What is the most appropriate assessment?

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Correct answer: A — Assess for delirium and possible infection

A sudden change in behaviour in dementia suggests delirium, and fever with suprapubic tenderness needs assessment for infection. Increasing donepezil, assuming dementia progression, benzodiazepines and annual review alone miss the acute cause. New behavioural disturbance in dementia should trigger a search for pain, infection, retention or constipation.

Reference: NICE CG103; NICE NG97