Case 2

Margaret is an 81 year old lady. Her daughter has been advised by her GP to bring her to the ED because she is more confused than usual over the past few days. She has become increasingly agitated, her oral intake has declined, she has new urinary incontinence and she is sleeping in the chair for most of the day and not sleeping at all at night.

Her daughter, whom she lives with, has noticed increasingly poor short term memory and cognitive decline over the last 12 months or so but she has deteriorated significantly over the last few days.

She has a past history of:

• IHD with pervious PCI

• Hypertension

• Hypercholestolaemia

• Polymyalgia rheumatica

• Depression

Her observations at triage are within normal limits

Question 1

What is the term for the condition Margaret is presenting with?

Question 2

What is your differential diagnosis?

Question 3

How do you differentiate between Margaret’s condition and dementia?

Question 4

What are our first line investigations?