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Delirium presenting as agitation — RCPSC EM MCQ

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ModeratePsychiatric emergenciesDelirium presenting as agitationRCPSC EM

A 76-year-old from long-term care is labelled as anxious and agitated. He is inattentive, fluctuates during the interview, T 38.4°C, HR 116, oxygen saturation 90%, and urinalysis is positive for nitrites. What is the most likely diagnosis?

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Correct answer: A — Delirium from acute medical illness

Acute fluctuating inattention with fever and hypoxaemia is delirium due to medical illness rather than a primary psychiatric presentation.

Reference: Canadian Coalition for Seniors' Mental Health delirium guidance; emergency geriatrics standards