Acute confusional state

Question 1

Factors predisposing to acute confusional state

Answer 1

age > 65 years
dementia
significant injury e.g. hip fracture
frailty or comorbidity
polypharmacy

Question 2

Acute events which could precipitate acute confusional state

Answer 2

infection (e.g. UTI)
metabolic: e.g. hypercalcaemia, hypoglycaemia, hyperglycaemia, dehydration
change of environment
severe pain
alcohol withdrawal
constipation

Question 3

Features of acute confusional state

Answer 3

memory disturbance (loss of short term)
agitated/withdrawn
disorientation
mood change
visual hallucinations
disturbed sleep cycle
poor attention

Question 4

If sedatives need to be used, what is recommended by NICE?

Answer 4

haloperidol or olanzapine

In patients with Parkinson’s:
quetiapine and clozapine are preferred