Altered Mental Status Flashcards
What is stupor
profound depression of level of consciousness
What is delirium
acute confusional states with organic etiology. There is altercation in both the level of consciousness and content of thought. Reversible
What is dementia
slow deterioration of higher cortical function. These patients have a normal level of consciousness but thought content is affected. Cognitive function loss only. Not reversible
What is acute psychosis
loss of ability to distinguish reality from fantasy
What are some causes of AMS
Systemic illness Isolated organ system dysfunction Drug intoxication Drug withdrawal Trauma Neurologic disease Psychiatric illness
If altered level of consciousness is present consider what 4 life threatening things
Hypoxia or hypoglycemia
Sepsis
Hypertensive encephalopathy
Wernicke’s encephalopathy
what are 4 acute neurological d/o
Meningitis
Subarachnoid hemorrhage
Central nervous system trauma; subdural hematoma
Seizures
most frequent disorders causing altered behavior are common systemic disorders/infections?
Urinary tract infections
Pneumonia
physical exam for patients with AMS
head eyes--> pupils, EOMs neck pulm cardiac abdomen skin rectal neurologic
What can be found on the eye exam
Eye appearance Pupils Direct and consensual responses Unilateral dilated pupil– brain herniation (true emergency) Pinpoint pupils Funduscopic exam Eye movements
abdomen findings
infection, organomegaly, recent surgery, trauma, mass, chronic alcoholism, obstruction, ruptured AAA
what includes the full neurological testing
Glasgow Coma Scale/Level of consciousness Orientation Memory Cranial nerves Motor and sensory testing Deep tendon reflexes
What is the main goal of treatment for a patient with AMS
begins with ABCs
Main goal is stabilization and symptom relief
4 most common causes of AMS in geriatrics
Multifactorial
Medications
Infection
Metabolic
5 most common causes of AMS in pediatrics
Unlikely to be psychiatric Toxicology Infection Trauma/abuse Metabolic
