What’s Causing This Young Woman’s Altered Mental Status?

Click through each section to learn more about the case and refine your differential diagnosis.

A 28-year-old woman with metastatic breast cancer (bone and brain) was admitted to the hospital with dyspnea. On admission to the hospital, she was mentating normally. However, due to concerns about her respiratory status she was not permitted to eat or drink overnight. The following morning her respiratory status was unchanged but she was slow to respond to questions.

Your Assessment

Which of the following is the most likely diagnosis?

A. Infection
B. Increased intracranial pressure
C. Hypercapnia
D. Electrolyte abnormality
E. Seizure


About Global Morning Report

Global Morning Report (GMR) is a daily series of fun, interactive, and brief clinical cases for physicians and trainees to practice their clinical reasoning in just a few minutes each day. GMR is a medical education initiative from the Human Diagnosis Project.