Confusion Flashcards
1
Q
CAM (Cognitive Assessment Method)
A
1. Acute Onset and fluctuating course PLUS 2. Inattention AND EITHER 3. Disorganised thinking OR 4. Altered LOC (hypo/hyperalert, both)
2
Q
The 4AT test
A
- Alertness
- AMT4: age, DOB, birthplace, current year
- Attention: months backwards
- Acute and fluctuating course
3
Q
Delirium features
A
Memory disturbances Agitated (hyperactive) / withdrawn (hypoactive) Disorientation Mood change Visual hallucinations Disturbed sleep cycle Poor attention
4
Q
Predisposing factors
A
Alcohol excess Renal impairment Old age Dementia Frailty Polypharmacy Surgery Visual/ hearing impairment
5
Q
Underlying cause
A
Infection (urine, chest, biliary) Acute hypoxaemia Electrolyte imbalance Prescribed medicines MI Alcohol / best withdrawal Urinary retention Constipation
6
Q
Common drug groups
A
Opioid analgesics
Drugs with anticholinergic properties
Sedating drugs
Corticosteroids
Dihydrocodeine - direct effect or by causing constipation
Ferrous sulphate - constipation leading to delirium
Bendroflumethiazide - hyponatraemia or dehydration
7
Q
PINCHME
A
Pain Infection Nutrition Constipation Hydration / hypoxia Sleep Medication Environment
8
Q
Complications
A
Falls Pressure sores Hospital acquired infections Functional impairment Incontinence Over-sedation Malnutrition
9
Q
Investigations
A
Obs FBC, CRP, U&Es, calcium, TFTs, LFTs, glucose CXR ECG Pulse oximetry Urinalysis
10
Q
Pneumonia
A
C onfusion
U rea >7
RR > 30
BP <90, <60
65
11
Q
Standardised tools that assess cognition
A
MMSE AMTS10 GP cog MOCA Addenbrookes cognitive assessment (ACE III)
