Delirium on the Acute Medical Unit: An Elderly Woman with a Urinary Tract Infection
A branching clinical case simulation for a patient presenting with new confusion and agitation. Take a history, examine, investigate, diagnose and treat while the patient responds to every decision, then see the score by clinical domain with the reasoning for each mark.
Year 3medium20 min6 stages
- Patient
- 84 years, female
- Presenting complaint
- New confusion and agitation
- Decision stages
- History, Examination, Investigations, Diagnosis, Treatment, Monitoring
The presentation
You are a Year 3 medical student in the emergency department of a district general hospital. The triage nurse calls you over: 'Here is Margaret, an 84-year-old woman from a care home. She is newly confused and agitated. The care home staff say she has been feverish and has not eaten well for two days. She takes oxybutynin and codeine. We need to work out what is going on.'
What this case teaches
Diagnose delirium and its causes; review and stop deliriogenic drugs; treat the infection; use non-pharmacological measures first; avoid inappropriate sedation.
How the case unfolds
- 1Taking a HistoryHistory
- 2Systematic ExaminationExamination
- 3Requesting InvestigationsInvestigations
- 4Synthesizing the DiagnosisDiagnosis
- 5Management PlanTreatment
- 6Monitoring and Follow-upMonitoring
The decisions available at each stage, and what each one costs or earns, appear when you run the case.
Log in to run "Delirium on the Acute Medical Unit: An Elderly Woman with a Urinary Tract Infection"
A free account opens the simulator: the patient's observations move with your decisions, and every choice is scored and explained.
Taught in
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Educational content for students and clinicians in training. It does not replace professional judgement, local protocols or current prescribing information.