Confusion Hx/PEx

Question 1

Hx — Key aspects:

Answer 1

1. Include Hx from family members/caregivers when available.
2. Detailed time course of cognitive deficits (acute vs chronic).
3. Associated Sx (constitutional — incontinence — ataxia — hypothyroid symptoms — depression).
4. Screen for delirium (waxing/waning level of alertness).
5. Falls.
6. Medications (recent changes).
7. H/o stroke or other atherosclerotic vascular disease — syphilis — HIV risk factors — Alcohol — Vit B12 — FHx of Alzheimer.

Question 2

Key PEx:

Answer 2

1. Complete neuro exam + MMSE + gait.
2. ENT.
3. Heart.
4. Chest.
5. Abdomen.
6. Extremities.