Q:

A 37 year old woman was admitted for femur fracture repair after a RTA. On the 4th post- operative day she became confused and starts picking on her bed sheets and complains of seeing spiders all over. What is the most likely diagnosis?

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A 37 year old woman was admitted for femur fracture repair after a RTA. On the 4th post-operative day she became confused and starts picking on her bed sheets and complains of seeing spiders all over. What is the most likely diagnosis?


  1. Delirium tremens
  2. Wernickes encephalopathy
  3. Korsakoffs psychosis
  4. Psychotic depression

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The key is A. Delerium tremens. [withdrawal of alcohol due to hospital admission lead to delirium tremens. Warnicke’s encephalopathy has triad of i) mental confusion ii) abnormal eye movements & iii) unsteady gait. Korsakoff's syndrome cannot be diagnosed until the person has stopped drinking alcohol for several weeks, to enable the immediate symptoms of alcohol intoxication and withdrawal to subside. Features of Korsakoffs psychosis i) dementia, loss of short term memory ii) difficulty in acquiring new information or learning new skills iii) personality change iv) confabulation].

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