NREMT Emergency Medical Technician (EMT) Cognitive ExamMedical EmergenciesEasy
A 78-year-old male, a resident of a long-term care facility, presents with new-onset confusion, weakness, and a low-grade fever (100.4°F/38°C). His caregiver reports he has been less active and has a decreased appetite over the past 24 hours. There are no other obvious signs of illness. What is the MOST likely cause of his symptoms?
- AAcute myocardial infarction (AMI).
- BStroke.
- CGastrointestinal bleed.
- DUrinary tract infection (UTI).
Show answer & explanationAnswer & explanation
Correct answer: D. Urinary tract infection (UTI).
In elderly patients, infections, particularly urinary tract infections (UTIs), often present atypically with non-specific symptoms such as new-onset confusion, weakness, and a low-grade fever, rather than classic symptoms like dysuria. This makes UTI a very common and likely cause for the described symptoms in a geriatric patient.
Why the other options are wrong
- A. AMI typically presents with chest pain, shortness of breath, or radiating pain, not primarily confusion.
- B. Stroke would present with focal neurological deficits (e.g., one-sided weakness, speech changes), not general confusion and weakness.
- C. GI bleed would typically present with dark or bloody stools, vomiting blood, or signs of hypovolemic shock, not primarily confusion and low-grade fever.
Atypical UTI in Elderly
In older adults, urinary tract infections (UTIs) frequently present with non-specific symptoms like new-onset confusion, altered mental status, generalized weakness, or decreased appetite, often without the classic urinary symptoms.
- Confusion/altered mental status is a common sign of infection in the elderly.
- Low-grade fever can be significant in this population.
- Always consider infection as a cause of sudden decline in geriatric patients.
- UTIs are among the most common infections causing these atypical presentations.
Memory trick: Old minds get fuzzy, low fever, weak body? Think 'Urinary'!