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A3-CORD curriculum > Approach to AMS > Flashcards

Approach to AMS Flashcards

1
Q

What are the ABCDEs?

A 
Airway
Breathing
Circulation
Disability (GSC scale)
Expose (fully undress)
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2
Q

What are the 6 things that all patients with AMS need, besides ABCs?

A
  1. Cardiac monitor
  2. Pulse ox / oxygen
  3. POC Glucose
  4. IV access
  5. Trauma eval
  6. Naloxone if narcotic overdose
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3
Q

What is a classic cause of AMS in the winter months, that causes a HA and patients to get better when they’re in the ED without any intervention?

A

Carbon Monoxide

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4
Q

What are the five major CNS causes of AMS?

A
  • Tumor
  • Hemorrhage
  • Edema
  • Seizure
  • Dementia
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5
Q

What are the four major broad causes or systems that are associated/cause AMS?

A
  • CNS
  • Metabolic
  • Infectious
  • Pharmacologic/toxic
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6
Q

What are three major primary CNS infectious processes that can cause AMS?

A
  • Meningitis
  • Encephalitis
  • Abscesses
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7
Q

What are the components of the AEIOU TIPS mnemonic for causes of AMS?

A 
Alcohol
Epilepsy
Insulin
Oxygen/opiates
Uremia
Trauma and temp
Infection
Poisons/psychogenic
Shock/stroke
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8
Q

Categorize delirium, dementia, and psychosis in terms of: onset

A 
Delirium = rapid
Dementia = slow
Psychosis = variable
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9
Q

Categorize delirium, dementia, and psychosis in terms of: course of symptoms

A 
Delirium = fluctuating
Dementia = progressive
Psychosis = variable
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10
Q

Categorize delirium, dementia, and psychosis in terms of: level of consciousness

A 
Delirium = Altered
Dementia = normal 
Psychosis = variable
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11
Q

Categorize delirium, dementia, and psychosis in terms of: presences of hallucinations and/or what type

A 
Delirium = Visual hallucinations (related to external stimuli)
Dementia = None (usually)
Psychosis = auditory (related to internal stimuli)
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12
Q

Categorize delirium, dementia, and psychosis in terms of: physical exam findings (normal vs abnormal)

A 
Delirium = abnormal
Dementia = normal
Psychosis = normal
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13
Q

Categorize delirium, dementia, and psychosis in terms of: Prognosis

A 
Delirium = poor if cause not tx
Dementia = progressive
Psychosis = variable
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14
Q

Categorize delirium, dementia, and psychosis in terms of: general cause (organic vs functional)

A 
Delirium = organic
Dementia = organic
Psychosis = functional
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15
Q

Categorize delirium, dementia, and psychosis in terms of: vital signs (normal vs not)

A 
Delirium = Not normal
Dementia = normal
Psychosis = normal
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16
Q

What parts of the brain are responsible for arousal and cognition respectively?

A
  • Arousal = reticular activating system

- Cognition = cortices

17
Q

What is the appropriate way to approach a patient who you think haves psychosis?

A

R/o medical etiology first, then ship to psych if needed

18
Q

What cause of AMS has a good chance of affecting both the elderly and the young?

A

Polypharmacy

19
Q

Why is a complete exam of the skin in the AMS patient always indicated?

A

Fentanyl patches or infection sites

20
Q

What are the total score values for each of the Glasgow Coma scale areas?

A 
EYES = 4
MOUTH = 5
ARM/LEG = 6
21
Q

What are the components and scores for the eye portion of the GSC?

A 
4 = spontaneously
3 = loud voice
2 = To pain
1 = None
22
Q

What are the components and scores for the verbal portion of the GSC?

A 
5 = oriented
4 = confused
3 = inappropriate words
2 = incomprehensible sounds
1 = no sounds
23
Q

What are the components and scores for the motor portion of the GSC?

A 
6 = follows commands
5 = localizes to pain
4 = withdraws to pain
3 = abnormal flexion
2 = abnormal extension
1 = none
24
Q

What GSC score is an “indication” for intubation?

A

“less than 8, intubate”, although this has not been proven or studied. If a patient is declining fast, intubate

25
Q

Decreased level of consciousness with cranial nerve findings is a (___) lesion until proven otherwise.

A

Decreased level of consciousness with cranial nerve findings is a brainstem lesion until proven otherwise.

26
Q

What are you looking for with a GU/GI exam in the patient presenting with AMS?

A 
GU = anuric --> uremic encephalopathy
GI = bleeding, infx
27
Q

Petechiae in the pt with AMS should raise suspicion for what?

A

Meningococcal meningitis

28
Q

What is the appropriate imaging to use if you suspect a lesion in the brainstem? (CT or MRI)?

A

MRI

A3-CORD curriculum (23 decks)

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