American Board of Surgery Qualifying Exam (ABS QE) Practice Test

What are the two mandatory features required in the Confusion Assessment Method (CAM) for diagnosing delirium?

1. Normal attention and absence of confusion

2. Evident acute change and disorganized thinking

3. Acute change in mental status and inattention

4. Fluctuating course and increased vigilance

The correct answer is: Acute change in mental status and inattention

The Confusion Assessment Method (CAM) is a widely used tool for diagnosing delirium, and it requires two mandatory features to make an accurate diagnosis. The correct answer identifies these essential components: an acute change in mental status and inattention. An acute change in mental status refers to a sudden alteration in a person’s cognitive function that is distinct from their baseline status. This change might be observed over hours to days and can manifest as confusion, disorientation, or altered level of consciousness. Inattention, on the other hand, means difficulty focusing, sustaining, or shifting attention. This can be evidenced by the patient being easily distracted or unable to complete a simple task. Together, these features help differentiate delirium from other cognitive disorders like dementia or depression, which often have different underlying mechanisms and presentations. Recognizing these features is crucial for timely and accurate diagnosis and management of delirium, particularly in clinical settings where the acute onset is indicative of underlying medical issues that may require immediate attention.