delirium

Question 1

what is delerium

Answer 1

acute, transient but reversible state of confusion

Question 2

what can cause delirium

Answer 2

usually an organic process like infection, drugs, dehydration
practically anything can cause delerium

Question 3

what are the two types of delirium

Answer 3

hyperactive
hypoactive
patients can fluctuate between the two

Question 4

clinical features of hyperactive delirium

Answer 4

agitation
delusions 
hallucinations
aggression 
wandering

Question 5

clinical features of hypoactive delirium

Answer 5

lethargy
slowness
excessive sleeping
inattention

Question 6

what tests can you do in delirium

Answer 6

urinalysis
bloods
CT head

Question 7

how do you manage delirium

Answer 7

create good environment - room with clock, radio on, access to aids like walking sticks, involve family
try and avoid medication
haloperidol (anti-psychotic) is 1st line
can use benzodiazepines - lorazepam is first line
promethazine (anticholinergic) sedative effect, caution in elderly