Delirium

Question 1

Delirium is defined by

Answer 1

Acute onset of cognitive impairment
And disturbance of consciousness
Delirium is a syndrome not a disease

Question 2

Onset and improvement of delirium

Answer 2

Sudden in onset
Rapid in improvment when the cause is known

Question 3

Delirium by other names

Answer 3

Sundowning
Encephalitis
Encephalopathy
Acute brain failure
ICU psychosis

Question 4

Delirium is characterized by

Answer 4

_decrease in consciousness
-decrease in cognition
-decrease in attention
-sleep cycle and mood abnormalities

Question 5

Severity and reversibility of delirium

Answer 5

Reversible /life threatening condition

Question 6

The sleep of delirum patient characterized by

Answer 6

Fragmented sleep at night /with or without morning drowsiness

Question 7

Mood alteration in patient with delirium

Answer 7

Subtle irritability to obvious dysphoria

Question 8

Epidemiology of delirium

Answer 8

More in elderly patients
13% 85 years old
1% 55 years old
0.4 % 18 years old

Question 9

Which patient are more likely to have delirium

Answer 9

Ealderly
ICU patients
Cardiac surgery
Terminal ill cancer patient
Post op patient

Question 10

Risk factor for having delirium

Answer 10

Advanced age
Polypharmacy
Alcoholic
Male
Hearing or vision impairment
History of delirium
Terminal ill

Question 11

Causes of delirium according to dsm5

Answer 11

*Substance intoxication
—alcohol ,cocaine,digoxin,narcotics
*Substance withdrawal delirium
—alcohol and benzodiazepines
*Medication induced delirium
—benzodiazepines,steroid,anticholinergic
*delirium due to medical condition
—mass lesion, metabolic causes ,infection

Question 12

Delirum is classified according to psychomotor activity into 3 types

Answer 12

Mixed type -
*between hyperactivity and hypoactivity *most common type
*psychomotor activity may remain stable at baseline or fluctuate rapidly

Question 13

Mixed type of delirium is characterized by

Answer 13

Mixed type -
*between hyperactivity and hypoactivity *most common type
*psychomotor activity may remain stable at baseline or fluctuate rapidly

Question 14

Hypoactive type of delerium is characterized by

Answer 14

Decrease in psychomotor activity
Raining from drowsiness to lethargy

Question 15

Hyper active type of delerium is characterized by

Answer 15

Less common type
Associated with drug intoxication and withdrawal symptoms
Presented with mood liabilty and agitation

Question 16

Criteria of delirium according to the dsm5

Answer 16

-decrease in attention
-disturbance in cognitive domain
-develop acutely (from hours to days )
-not explained by other neurocognitive disorder
-not due to coma
-evidence that this condition is according to coma

Question 17

Labs and imaging for delirium

Answer 17

Blood alcohol level
Urine Drug screen
Therapeutic drug level
Head imaging with eeg
CBC
Abg

Question 18

Treatment for delirium

Answer 18

Identify the underling cause
Maintain nutrition /hydration /electrolytes
Haloperidol for agitation treatment
Benzodiazepines is avoided unless if the cause of delirium is alcohol or benzodiazepine withdrawal