When evaluating altered mental status, which of the following should be assessed as part of the differential?

• A. Glycemic emergency, stroke, drug use, or toxic ingestion
• B. All infectious etiologies only
• C. Only alcohol intoxication
• D. Allergic reaction

Answer: (A)

When someone has altered mental status, you look for a broad, time‑critical differential that includes reversible and life‑threatening causes. The best option lists glycemic emergencies, neurologic events like stroke, and toxicologic causes from drugs or other ingestions. This covers the most common and urgent reasons for AMS that you must identify quickly, so you can treat promptly (for example, giving glucose for hypoglycemia, initiating stroke protocols, or managing overdoses with appropriate antidotes and supportive care). Other choices are too narrow: focusing only on infectious etiologies misses metabolic and toxic causes; limiting to alcohol intoxication ignores stroke and other reversible problems; and allergic reaction isn’t a primary driver of AMS in most cases.