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Delirium from urinary infection — SCE Acute Medicine MCQ

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EasyAcute Neurological PresentationsDelirium from urinary infectionSCE Acute Medicine

A 86-year-old woman is assessed on the acute medical unit. She has fluctuating attention, visual misperceptions and acute confusion over 24 hours. Urinalysis is positive and sodium is normal. Initial assessment includes relevant observations, bedside tests and urgent blood results. What is the most likely diagnosis?

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Correct answer: A — Delirium

Delirium is the best answer because acute fluctuating disturbance of attention and cognition is delirium, likely precipitated by infection. Tension pneumothorax is plausible, but it is less appropriate for the physiology or timing described in this stem. The other distractors either fit a neighbouring presentation, delay definitive treatment, or miss the key immediate risk. Clinical pearl: Delirium is a syndrome; identifying and treating triggers is central.

Reference: NICE CG103