skip to main content

Delirium superimposed on dementia — SCE Geriatric Medicine MCQ

Instant feedback + full explanation. One question, done properly.

HardDeliriumDelirium superimposed on dementiaSCE Geriatric Medicine

A care-home resident with stable moderate dementia has malodorous urine but no dysuria, frequency, suprapubic pain, fever, haemodynamic change or new delirium. Urine culture sent without indication grows E. coli above 10^5 CFU/mL. What is the best action?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: ADo not treat asymptomatic bacteriuria; reassess if symptoms develop

Explanation lettering: E = shown as C · C = shown as D · D = shown as E

A is correct: this is asymptomatic bacteriuria in a non-pregnant adult and routine treatment provides no benefit while increasing adverse effects and resistance. B treats a laboratory result rather than a syndrome. C assumes dementia automatically supplies symptoms. D perpetuates unnecessary screening. E overinterprets malodour without new urinary or systemic features.

Reference: NICE NG109 lower UTI recommendations: https://www.nice.org.uk/guidance/NG109/chapter/recommendations