Delirium is part of the Neurocognitive Disorders section of Psychiatry. Practise 14 exam-style MCQs for NEET PG, FMGE, INI-CET and NEET SS, each with the correct answer and a detailed explanation.
Delirium MCQs test the acute confusional state in all its forms — fluctuating orientation, hypoactive presentations, the acetylcholine hypothesis, and delirium superimposed on dementia — high-yield NEET PG psychiatry.
Sample Delirium MCQs with answers
Sample MCQ #1
A 70-year-old man admitted in an intensive care unit suddenly develops fluctuation in orientation to time, place and person along with sleeplessness, aggressive behaviour and visualisation of small insects and animals. All of the following terms can be used to describe his condition except:
AAcute brain failure
BCerebral insufficiency
CMeningeal irritation
DOrganic Brain syndrome
Show Answer & Explanation ▾
✓ Correct Answer: C. Meningeal irritation
The above-mentioned case scenario represents delirium. Various terms describing delirium are as follows: Acute confusional state Acute brain failure Encephalitis Encephalopathy Intensive care unit psychosis Toxic metabolic state Central nervous system toxicity Paraneoplastic limbic encephalitis Sundowning Cerebral insufficiency Organic brain syndrome Reference : Kaplan and Sadock’s Textbook of Psychiatry, 11 th edition, Chapter 21.2 Delirium, Page number 697.
Sample MCQ #2
In a 72-year-old diabetic patient having chronic renal failure, functionally dependent for daily activities on others, and also having moderate hearing impairment, which of the following characteristics carries the highest risk of predisposing the patient to an episode of delirium?
AAdvanced age
BMale gender
CChronic renal impairment
DHearing impairment
Show Answer & Explanation ▾
✓ Correct Answer: A. Advanced age
Advanced age is a major risk factor for the development of delirium. Approximately 30 to 40% of hospitalized patients older than age 65 years have an episode of delirium. Reference: Kaplan and Sadock’s Textbook of Psychiatry, 11 th edition, Chapter 21.2 Delirium, Page number 698.
Sample MCQ #3
A 70-year-old woman was brought to the emergency department by the police due to complaints from her neighbours for wandering around the neighbourhood without clothes and poor self-care since last 5 days. When found by the police, she was dirty, foul-smelling, in a half-naked state, with garbage and rotting food all over her house. When interviewed, she appeared confused, disoriented, not able to recognise where she was and was unresponsive. Which of the following neurotransmitter and neuroanatomical area could majorly be implicated for her present confused condition?
AGlutamate; Cerebellum
BAcetylcholine; Cerebral cortex
CGlutamate; Nucleus Accumbens
DAcetylcholine; Reticular formation
Show Answer & Explanation ▾
✓ Correct Answer: D. Acetylcholine; Reticular formation
The major neurotransmitter hypothesized to be involved in delirium is acetylcholine and the major neuroanatomical area is the reticular formation. Reference: Kaplan and Sadock’s Textbook of Psychiatry, 11 th edition, Chapter 21.2 Delirium, Page number 699.
Sample MCQ #4
A 66-year-old woman recently operated for fracture of femur around two days' back presents with episodes of getting disoriented, behaving as if she is at her native village, remaining sleepy, stuporous and giving sluggish responses. Which of the following types of acute confusional state describes her condition?
AHyperactive delirium
BHypoactive delirium
CMixed level of activity delirium
DNone of the above
Show Answer & Explanation ▾
✓ Correct Answer: B. Hypoactive delirium
In hypoactive delirium, the individual has a hypoactive level of psychomotor activity that may be accompanied by sluggishness and lethargy that approaches stupor. Reference: Kaplan and Sadock’s Textbook of Psychiatry, 11 th edition, Chapter 21.2 Delirium, Page number 700.
Sample MCQ #5
Which of the following mechanism is implicated in cerebral insufficiency caused by head trauma?
ALack of acetylcholine
BDopaminergic excess
CExcitatory neurotoxicity by glutamate
DAll of the above
Show Answer & Explanation ▾
✓ Correct Answer: D. All of the above
Pathophysiological mechanisms involved in delirium: Neurotransmitter mechanism- Decrease in levels of acetylcholine Increase in levels of dopamine (reciprocal acetylcholine-dopamine balance) Increase in glutamate levels (Excitatory neurotoxicity causing neuronal damage) Increase in GABA levels (implicated in hepatic encephalopathy, delirium secondary to benzodiazepine and alcohol withdrawal) Other neurotransmitters like norepinephrine and serotonin may also have a role Inflammation (Delirium as a CNS response to systemic inflammation)- Cytokines (IL-1, IL-2, IL-6, TNF-a, interferon) may contribute to delirium by increasing permeability of blood-brain-barrier and altering neurotransmission. Reference: Kaplan and Sadock’s Comprehensive Textbook of Psychiatry, 10 th edition, Chapter 10.2 Delirium, Page number 3052.
Sample MCQ #6
A 46-year-old chronic alcoholic (heavy prolonged drinking) presents with altered sensorium, frequent disorientation, and stuporous state. Laboratory investigations show highly deranged liver enzymes. Which of the following mechanism is responsible for encephalopathy stage in this patient?
ALack of acetylcholine
BHyper ammonaemia
CIncreased GABA levels
DBoth b) and c)
Show Answer & Explanation ▾
✓ Correct Answer: D. Both b) and c)
Hepatic encephalopathy (following prolonged heavy use of alcohol) has been associated with increased GABA and serum ammonia levels. Ammonia and several other factors are known to induce and aggravate astrocyte swelling that initiates a cascade of events leading to delirium. In addition, elevated ammonia levels can contribute to increased glutamate and glutamine levels, which are precursors to GABA. Reference: Kaplan and Sadock’s Comprehensive Textbook of Psychiatry, 10 th edition, Chapter 10.2 Delirium, Page number 3052.
Sample MCQ #7
In a patient having parkinsonian features presenting in a delirious state, all of the following statements hold true except;
AAntiparkinsonian agents are protective in delirium
BClozapine is the safe antipsychotic in this condition
CUse of haloperidol is associated with worsening of parkinsonian features
DRisperidone should be avoided
Show Answer & Explanation ▾
✓ Correct Answer: A. Antiparkinsonian agents are protective in delirium
In Parkinson’s disease, the antiparkinsonian agents are frequently implicated in causing delirium. If delirium persists after attenuation of antiparkinsonian agents, clozapine is recommended. Use of other antipsychotics like haloperidol or risperidone is associated with worsening of parkinsonian features in such patient. Reference: Kaplan and Sadock’s Textbook of Psychiatry, 11 th edition, Chapter 21.2 Delirium, Page number 703.
Sample MCQ #8
Sometimes patient of dementia may develop superimposed delirium. This is called as:
ADouble depression
BDouble dementia
CBeclouded dementia
DCatastrophic reaction
Show Answer & Explanation ▾
✓ Correct Answer: C. Beclouded dementia
Dementia with Delirium. It is called as beclouded dementia. Reference: Kaplan and Saddocks Synopsis of Psychiaitry, 11th Edition, Chapter 21, Page No.: 701
What you can practise in Delirium
14 Delirium MCQs on Neurocognitive Disorders — each with detailed explanations
Previous-year question practice across NEET PG, FMGE, INI-CET and NEET SS
Progress and performance tracking to measure retention
Delirium MCQs test the acute confusional state in all its forms — fluctuating orientation, hypoactive presentations, the acetylcholine hypothesis, and delirium superimposed on dementia — high-yield NEET PG psychiatry.
How many Delirium questions are there, and which exams do they cover?
MedLadder includes 14 curated MCQs for Delirium under Psychiatry (Neurocognitive Disorders), covering NEET PG, FMGE, INI-CET and NEET SS preparation.
