Altered Mental Status

Question 1

What is the Gambit?

Answer 1

1. 02
2. 02 sat
3. IV
4. cardiac monitor
5. 12 lead +/- CXR

Question 2

5 Causes of AMS

Answer 2

1. Vital Sign Abnormality
2. Toxic/Metabolic
3. Structural Lesion
4. Infectious
5. Psychiatric

Question 3

What do you order when you believe primary cause of AMS is toxic/metabolic?

Answer 3

1. Glucose
2. BMP
3. ABL
4. UDS
5. Calcium

Question 4

What do you do if you suspect a structural cause of AMS?

Answer 4

Order CT! they are cheap

Question 5

What do you order if you suspect an infectious cause of AMS?

Answer 5

1. CBC
2. LP
3. Blood cultures
4. UA
5. CXR

Question 6

3 Main causes of meiosis?

Answer 6

1. Opiates
2. Pontine bleed
3. Cholinergic Drugs
   Bonus: Organophosphate poisoning = SLudge

Question 7

3 main causes of mydrasis

Answer 7

1. Anti- cholingergics
2. stimulants
3. diffuse cortical dysfunction

Question 8

Doses of Narcan for 3 patient populations..

Answer 8

.4 = iatragenic overdose
1-2= opiate users
10= ROCCAUA drug tox

Question 9

Worst potential side effects of too much Narcan ( RARE!)

Answer 9

Pulmonary edema and HTN

Question 10

Causes of Hypoglycemia?

Answer 10

ReExPLAINED

1. Renal
2. Exogenous
3. Pituitary/ACTH
4. Liver
5. Alcohol/ Addisons
6. Infection ( especially in kids- sepsis until r/o)
7. neoplasm
8. Drugs

Question 11

What does D50 mean?

Answer 11

2g mg of glucose in 50 cc water. its always grams over 100 cc

Question 12

What is the toxicity for thiamine?

Answer 12

NONE

Question 13

5 causes of thiamine deficiency

Answer 13

1. Chronic malnutrition ( homeless)
2. Chronic malabsorbtion ( short gut)
3. anorexic
4. pregnant
5. Chronic alcoholics

Question 14

What is the dose of thiamine you give?

Answer 14

100 mg IV

Question 15

What is the differential for seizures?

Answer 15

Same as AMS, but instead of psych add epilepsy