Confusion Flashcards

1
Q

What syndromes can cause a patient to appear confused (6)

A
Delirium
Dementia
Mental impairment
Psychosis
Receptive dysphasia
Expressive dysphasia
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2
Q

What area is damaged in receptive dysphasia

A

Wernicke’s area

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3
Q

What area is damaged in expressive dysphasia

A

Broca’s area

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4
Q

Damage to Wernicke’s area causes what

A

Receptive dysphasia

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5
Q

Damage to Broca’s area causes what

A

Expressive dysphasia

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6
Q

What topics do the questions of the AMTS cover and how many questions in each area?

A
Orientation in time 3
Orientation in space 1
Orientation in person 1
Long term memory 3
Short term memory 2
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7
Q

What are the questions of the AMTU?

A

Orientation in time
What time is it (nearest hour)? What year are we in?
How old are you?

Orientation in space
What building are you in?

Orientation in person
Who am I? Who is that person (e.g. nurse)?

Long-term memory
What is your date of birth?
What year did the Second World War end (or alternative date, e.g. particular Olympic Games)? Who is the current Prime Minister?

Short-term memory
Please count backwards from 20 to 1. Can you remember the address I told you?

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8
Q

What should you ask for a quick screen of confusion? (7)

A

AMTS
Can they follow a three step command? (Testing receptive dysphasia)
Can they name three common object? (Testing expressive dysphasia)
Are they in pain?
Breathlessness?
Cough?
Urinary symptoms?
(As a chest or UT infection is the most common cause of confusion)

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9
Q

If a confused patient is accompanied by someone else, what should you try ascertain from them? (

A

Normal state
Time course of their confusion
DHx including alcohol (both introduction and cessation of drugs can induce delirium)

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10
Q

What does an acute onset of confusion argue against and for?

A

An acute onset argues against dementia

and in favour of delirium.

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11
Q

INVITED MD

First I causes of confusion? (5)

A

Infectious (e.g. chest, urinary, encephalitis, brain abscess, sepsis)

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12
Q

What mnemonic can help remember causes of confusion?

A

INVITED MD

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13
Q

INVITED MD

N causes of confusion?

A

Neoplastic (e.g. brain tumour)

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14
Q

INVITED MD

V causes of confusion? (2)

A

Vascular (e.g. stroke, myocardial infarction causing hypoperfusion)

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15
Q

INVITED MD

Second I causes of confusion? (2)

A

Immune (e.g. rare conditions such as neuropsychiatric lupus, Hashimoto’s encephalopathy)

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16
Q

INVITED MD

T causes of confusion? (2)

A

Trauma (e.g. subdural haematoma, extradural haematoma)

17
Q

INVITED MD

E causes of confusion? (3)

A

Endocrine (e.g. hypothyroidism, hyperthyroidism, diabetic ketoacidosis)

18
Q

INVITED MD

D causes of confusion? (6)

A

Drugs (e.g. intoxication or withdrawal of alcohol, opiates, or psychiatric medications; or use of diuretics, digoxin, thyroid medication). Drug toxicity accounts for 30% of delirium

19
Q

INVITED MD

M causes of confusion? (7)

A

Metabolic (e.g. hypoxia, hypercapnia, hypoglycaemia, sodium or other electrolyte imbalances, thiamine, folate, or vitamin B12 deficiencies)

20
Q

INVITED MD

D causes of confusion?

A

Degenerative conditions. These will be chronic and will not cause the delirium, but they will predispose patients to becoming delirious

21
Q

A cause of confusion that isn’t in INVITED MD?

A

Hypothermia