Overview
Introduction
Delirium is an acute, fluctuating disturbance in attention and cognition that develops over hours to days and represents an underlying medical emergency.
Delirium is an acute, fluctuating disturbance in attention and cognition that develops over hours to days and represents an underlying medical emergency. Unlike dementia which develops gradually and is irreversible, delirium has rapid onset, fluctuating course, and is potentially reversible when the underlying cause is treated. The mnemonic I WATCH DEATH identifies common causes: Infections, Withdrawal, Acute metabolic, Trauma, CNS pathology, Hypoxia, Deficiencies, Endocrine, Acute vascular, Toxins/medications, Heavy metals. Hypoactive delirium (quiet, withdrawn) is frequently missed compared to hyperactive delirium (agitated, hallucinating). The Confusion Assessment Method (CAM) is the validated screening tool. On the exam, writers often pair stable-sounding options with unstable data—notice the mismatch before you commit. If the stem names a license or role, reread that line; scope errors are classic trap answers even when the clinical topic is familiar. Run a 60-second scan: breathing work and oxygenation, perfusion and end organs, neuro baseline, likely infection sources, and devices that can fail quietly. When two answers feel partly right, pick the one that reduces imminent harm and matches orders for the role you were given. Train yourself to...
