shawn333
Forum Senior
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15A 60-year-old male executive with a history of angina pectoris and
depression had bypass surgery the previous day. His depression has
responded well to selective serotonin reuptake inhibitors (SSRIs)
and there is no history of psychosis in the past. He now presents
with confusion, agitation, irritability, and tries to remove his
IV lines. His level of consciousness fluctuates, and at times he
forgets who he is. He is given a neuroleptic drug, and appears
much improved. What is the most likely diagnosis?
A. Adjustment disorder
B. Delirium
C. Dementia
D. Exacerbation of depression with suicidal ideation and psychotic features
E. Schizophrenia
Answer
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| bluedusk
Forum Elite
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take B because of the acuteness of the attack and the responsiveness to neuroleptics.
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| mjl1717
Forum Hero
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answer b -because of impaired consciousness and agitation
[the response to SSRI rules out psuedodementia]
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| shawn333
Forum Senior
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yes but the answer guide says , A , can they be right ?
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| bluedusk
Forum Elite
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i just back to the study guide i had where i thought i'd seen this one before. the answer there is "b".
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| H.of.Troy
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it's B because as KAPLAN's points "most cases of delirium occur in HOSPITALIZED patients-10-15% of acute medical/surgical pts!) 
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| polkos
Forum Senior
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i'd go with A 'cos this looks like adj disorder following a stressful event...as far as delirium i don't think it's the ans as no clue of infection or drug abuse. any comments??
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