Neurocognitive disorders: The Daily PANCE Blueprint
An 80-year-old man is admitted to the hospital for pneumonia. On the second day of admission, he becomes increasingly confused, agitated, and disoriented. His vitals are stable, and his oxygen saturation is 96% on room air. What is the most likely diagnosis?
A. Alzheimer's disease
B. Delirium
C. Stroke
D. Schizophrenia
E. Major depressive disorder
Answer and topic summary
The answer is B. Delirium
The correct answer is Delirium. The patient’s acute onset of confusion, agitation, and disorientation in the setting of hospitalization for pneumonia is highly suggestive of delirium. Delirium is a common syndrome in hospitalized older adults and is often triggered by infection, medications, or metabolic derangements. It requires prompt identification and treatment of the underlying cause. Supportive measures such as reorientation and minimizing the use of restraints are also important.
- A. Alzheimer’s disease: Alzheimer’s is a chronic condition that would not present acutely. It also typically has a gradual onset and progression.
- C. Stroke: While stroke can cause acute changes in mental status, other focal neurologic signs are usually present.
- D. Schizophrenia: This is a chronic psychiatric condition and would not present acutely in this manner.
- E. Major depressive disorder: Depression could cause cognitive changes but would not likely present with acute confusion and agitation.
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Smarty PANCE Content Blueprint Review:
Covered under ⇒ PANCE Blueprint Neurology ⇒ ⇒
Also covered in Internal Medicine, and Family Medicine PAEA EOR topic lists
