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

Which of the following is a metabolic etiology for delirium?

1. Increased Vitamin D

2. Hypoglycemia

3. High blood pressure

4. Chronic fatigue syndrome

The correct answer is: Hypoglycemia

Hypoglycemia is a recognized metabolic etiology for delirium. Delirium, which presents as an acute change in mental status and confusion, can be triggered by various metabolic disturbances, and low blood sugar levels can significantly affect brain function. When glucose levels drop too low, the brain, which relies heavily on glucose for energy, can become impaired, leading to symptoms such as confusion, agitation, and altered levels of consciousness. Other options do not typically lead to delirium through metabolic means. Increased Vitamin D is generally associated with health benefits rather than causing delirium. High blood pressure, while a significant health issue, does not directly cause delirium. Chronic fatigue syndrome is a complex condition but is not directly linked to the metabolic disruptions that would result in delirium. Thus, hypoglycemia stands out as a clear metabolic trigger that can precipitate this acute confusional state.