Confusion, Free CME Quiz, Earn CME Credit
A free Confusion question included below. The full Confusion CME quiz is free online for a limited time. You can earn AMA CME credit - and now you can earn ANCC contact hours as well! Play now.
Here's this week's sample CME board review question on Confusion:
A 22-year-old woman with schizophrenia and multiple sclerosis presents to you in an agitated state.
Per her family, she is usually functional and has done well with her chronic underlying diseases until now.
She is unable to describe where she is, what day of the week it is, or how she got here, but she is awake and alert.
Which of the following would be a key finding on physical examination to narrow the differential diagnosis of this patient's confused state?
The correct answer is:
temperature of 40°C
Discuss signs that provide an early focus within the very broad work-up of a patient with confusion.
Any physician knows that looking at the vital signs is an important first step in ANY patient; however, it is surprisingly often forgotten in the confused patient.
A complete set of vital signs, including temperature, is a critical component of evaluating confusion and may yield important clues that initiate a more specific search – in this case a physical search for physical cues of infection (cellulitis, abscess, etc), and also urine and cerebrospinal fluid analysis, a chest x-ray, various lab tests (WBC, etc) and blood cultures.
Other etiologies must of course also be kept in mind; however, an infectious work-up will be a higher priority in a patient with a significant fever than a patient with completely normal vital signs.
Well-healed scars yield information about past events, but do not focus the differential work-up in this patient.
Huff JS. Confusion. (Chapter 14) In: Walls R, et al. Rosen’s Emergency Medicine: Concepts and Clinical Practice. 9th ed., 2018: 132-137e.
Play the full Med-Challenger Quick Quiz for CME Credit:
Every free board review "Question of the Week" is just a sampling of a larger set of free board review questions featured in Med-Challenger's latest CME Quick Quiz.
Our insanely popular CME Quick Quiz provides FREE board review questions and the opportunity to earn free CME credits every week. It's a fun way to stay up-to-date and see how your knowledge ranks with peers. All you need is a free online Med-Challenger account. Most recent 5 quizzes are available. Sign up now.
Med-Challenger provides online medical education exam review and continuing medical education products and services to physicians, nurses, and other medical specialists as well as learning management systems for medical training programs and healthcare groups world-wide via its web-based medical education library and world-class assessment platform at https://app.challengercme.com.