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A 58-year-old man was admitted three and a half days ago after a fall from a ladder; his wife said he drinks nightly at the club. He was settled and oriented for two days. Tonight he is shouting, sweating through his gown and brushing things off his forearms that nobody else can see; his hands shake coarsely as he reaches for the water jug, and he thinks he is at the races. Pulse 116/min, blood pressure 158/94 mmHg, temperature 37.6 degrees C. Eye movements are full, the chest is clear and there is no jaundice. Which one of the following best explains tonight's change in his mental state?
Shared by Mornienmiddle twist

Keep going — a set of ten like this one, one at a time.

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