What should be assessed in all patients with altered mental status?

• A. Serum amyloid
• B. Blood glucose level (BGL)
• C. Lipid profile
• D. Creatinine clearance

Answer: (B)

In altered mental status, quickly ruling in or out reversible, life-threatening causes is essential. The blood glucose level is the most important test to perform in every case because glucose abnormalities are a common, immediately correctable reason for AMS. If it's too low, you can treat right away with glucose; if it's high, you address it within the broader metabolic context. This bedside check is fast, inexpensive, and directly guides urgent management.

The other tests don’t fit as universal initial assessments. Serum amyloid isn’t part of the acute AMS evaluation and isn’t something you act on immediately in an unconscious or confused patient. A lipid profile and creatinine clearance provide information about long-term health or kidney function but don’t explain or resolve an acute change in mental status and won’t typically change immediate treatment. If glucose is normal, proceed with the broader workup as indicated by the clinical picture.