Delirium: The Daily PANCE Blueprint

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Delirium: The Daily PANCE Blueprint

A 78-year-old woman with a history of hypertension and type 2 diabetes is brought to the emergency department by her daughter due to acute confusion and disorientation over the past two days. The patient has had increasing difficulty recognizing her family members and has been agitated and restless. Her vital signs are: temperature 37.8°C (100.0°F), blood pressure 145/80 mm Hg, pulse 88/min, and respiratory rate 16/min. Laboratory tests reveal a blood glucose level of 110 mg/dL, creatinine of 1.1 mg/dL, and a normal complete blood count. Which of the following is the most common cause of delirium in an older patient population?

A. Dehydration
B. Urinary tract infection
C. Medication side effects
D. Electrolyte imbalance
E. Stroke

Answer and topic summary

The answer is B. Urinary tract infection

The most common cause of delirium in older patients is a urinary tract infection (UTI). Delirium is an acute and fluctuating disturbance of consciousness and cognition, often triggered by underlying medical conditions in elderly patients. UTIs are particularly common in this age group and frequently present atypically, including with confusion and delirium rather than the classic urinary symptoms. Prompt recognition and treatment of the underlying infection can help resolve delirium.

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Smarty PANCE Content Blueprint Review:

Covered under ⇒ PANCE Blueprint Neurology ⇒ Neurocognitive disorders (PEARLS) ⇒ Delirium

Also covered in Internal Medicine, and Family Medicine PAEA EOR topic lists

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