Amnesia, dissociative disorders and delirium Quiz: Ace Your Exams

A 72-year-old woman is brought to the emergency department by their son for evaluation of confusion. The patient's son reports that he went to the patient’s apartment to check on the patient and found her lying on the ground. The son explains that “She couldn’t tell me what happened, so I called 911.” The patient’s past medical history includes hypertension, hyperlipidemia, diabetes, and a recent left femoral neck fracture. The patient’s current medications include lisinopril, metformin, atorvastatin, ibuprofen, and acetaminophen. The patient is currently employed as a lawyer and has been working at home since the fracture. Temperature is 38.3°C (100.9°F), pulse is 104/min, respirations are 22/min, blood pressure is 107/70 mmHg, and O₂ saturation is 93% on room air. Initial assessment demonstrates an elderly female who appears confused. The patient states, “What you are trying to do to me here is illegal. You are trying to lock me up and throw away the key!” Physical examination reveals a left lower extremity in a cast with adequate capillary refill and without other signs of injury or trauma. The patient is not physically abusive and follows directions given by the physician and nurses. A chest X-ray is demonstrated below.  Which of the following best describes the etiology of this patient’s confusion?


Reproduced from: wikipedia