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altered mental status

Practice targeted AMC-style multiple-choice questions on altered mental status.

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A GP working in a hospital is observed getting into arguments with colleagues. Later, a colleague finds her disoriented and walking in the hallway. What is the most appropriate initial step?

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Post-embolization arteriogram showing coiled aneurysm (indicated by yellow arrows) of the posteriorcerebral artery with a residual aneurysmal sac.
Image by Promod Pillai, Aftab Karim, Anil Nanda CC BY 2.0 · Source

A 68-year-old woman with a history of hypertension presents with a severe headache and altered mental status. Aneurysm coiling was performed. The image shows a post-operative angiogram. 6 hours later, she develops a fever of 38.5°C and worsening neurological deficits. What is the MOST likely cause?

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An 18-year-old teenage girl presents with a sudden change in behavior at a music festival, appearing confused and aggressive after consuming 5-6 vodkas, with uncertainty about illicit drug use. What is the most appropriate next step in her management in the Australian context?

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Post-embolization arteriogram showing coiled aneurysm (indicated by yellow arrows) of the posteriorcerebral artery with a residual aneurysmal sac.
Image by Promod Pillai, Aftab Karim, Anil Nanda CC BY 2.0 · Source

A 68-year-old woman with a history of hypertension presents with a severe headache and altered mental status. Aneurysmal coiling was performed. The image shows a post-operative angiogram. 6 hours later, the patient's GCS decreases. What is the MOST likely cause?

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An elderly man presents with a 6-month history of memory decline, recurrent falls, visual hallucinations, agitation, and confusion. His wife reports he talks to people who are not visible. Which of the following clinical features is most helpful in diagnosing his condition?

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A 43-year-old is unconscious with low blood glucose (1.8 mmol/L), has a history of insulin use and alcohol intake. What is the next step?

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Post-embolization arteriogram showing coiled aneurysm (indicated by yellow arrows) of the posteriorcerebral artery with a residual aneurysmal sac.
Image by Promod Pillai, Aftab Karim, Anil Nanda CC BY 2.0 · Source

A 68-year-old woman with a history of hypertension presents with a severe headache and altered mental status. Aneurysmal subarachnoid hemorrhage is confirmed. The aneurysm was coiled. The image shows a post-operative angiogram. 6 hours later, the patient's GCS decreases. What is the MOST likely cause?

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