2. Confusion Flashcards
What 6 syndromes can cause confusion?
Delirium Dementia Mental impairment Psychosis Receptive Dysphasia Expressive Dysphasia
What is delirium?
An acute impairment in cognitive ability with impaired consciousness
What is dementia?
Chronic progressive cognitive impairment with intact consciousness
What are the 10 components of AMTS?
What time is it? What year are we in? How old are you? What building are you in? Who am I? Who is that person (e.g nurse)? What is your date of birth? What year did WW2 end? Who is the current PM? Please count from 20 to 1 Can you remember the address I told you? (tell address at start)
What are 2 common infectious causes of confusion?
chest infection
urinary infection
Name a neoplastic cause of confusion
brain tumour
Name 2 traumatic causes of confusion
Subdural haematoma
Extradural haematoma
Name 3 drugs that may cause confusion
Diuretics
Digoxin
Thyroid medication
What are some of the signs of sepsis on examination?
Chest: dull percussion, crackles + bronchial breathing
Urine: suprapubic tenderness, cloudy urine
Cellulitis: red + warm
Meningitis: neck stiffness, photophobia + purpuric rash
What 3 investigations may you request for someone who presented with confusion?
Septic screen
Metabolic screen
ECG
What is mental impairment?
Permanent impairment of cognitive ability
What is psychosis?
Disorder of thought content/ perception (hallucination/ delusion)
What is receptive dysphasia?
Difficulty comprehending questions (Wernickes area damaged)
What is expressive dysphasia?
Difficulty verbalising an answer to questions (Brocas area damaged)
List 5 metabolic causes of confusion
Hypoxia Hyercapnia Hypoglycaemia Hypercalcaemia Sodium/ other electrolyte imbalance
List 4 causes of confusion that present with dilated, sluggish pupils
Drug overdose e.g. cocaine, TCAs
Severe hypoxia
Hypothermia
Postictal
List 2 causes of confusion that present with pin point, sluggish pupils
Opiate OD
Barbituate OD
What 8 signs should be looked for in a confused patient?
Consciousness Septic focus Pupils Focal neurological signs Needle track marks: IV drug abuse Asterixis: Hypercapnia, Hepatic encephalopathy, uraemia Breath for alcohol Bitten tongue: Seizure
