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

Which metabolic disturbance is NOT associated with delirium?

1. Hypercalcemia

2. Hypokalemia

3. Hypernatremia

4. Hypoglycemia

The correct answer is: Hypokalemia

Delirium is a complex neurocognitive disorder often associated with various medical conditions and metabolic disturbances. While several metabolic disturbances can contribute to the development of delirium, hypokalemia is less commonly linked to this condition. Hypercalcemia is a known cause, as elevated calcium levels can affect neuronal excitability and lead to confusion and disorientation. Hypernatremia can lead to significant osmotic shifts and central nervous system disturbances, including delirium. Similarly, hypoglycemia can result in insufficient glucose supply to the brain, leading to altered mental status and potentially delirium. In contrast, hypokalemia typically leads to muscle weakness and cardiac arrhythmias rather than direct alterations in mental status. While potassium levels are crucial for overall cellular function and neuromuscular transmission, disturbances in potassium are not primarily known to cause delirium. Therefore, the metabolic disturbance that is least associated with delirium is hypokalemia, making it the correct choice in this scenario.