Confusion and Delirium (Assessment & Diagnosis) — 79yo Man | Nephrology | MCCQE1 Q#13298
MCCQE1 Question #13298
Dimension of Care
Acute Care
Activity
Assessment & Diagnosis
Objective
Confusion and Delirium
Section
Medicine / Family Medicine
Subject
Nephrology
Last updated: February 2026
A 79-year-old man from a long-term care facility presents with 2 days of worsening confusion and lethargy during a gastroenteritis outbreak. Staff report poor oral intake, increased thirst, and recent watery diarrhea. Medications include hydrochlorothiazide and quetiapine. He has no known kidney disease. Examination shows dry mucous membranes, decreased skin turgor, clear lungs, and no peripheral edema. Laboratory studies reveal marked hypernatraemia with high serum osmolality and concentrated urine. What history element is most important to identify a common trigger of his hypernatraemia and anticipate clinical consequences?
Full answer analysis and choices are available inside the practice session.
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