delirium

Question 1

confusion screen

Answer 1

FBC - anaemia, infection, malignancy
U+E - hyponatraemia, hypernatremia
coagulation- bleed
TFT-s hypothyroid
Calcium - Hypercalcaemia
B12+ Folate
glucose
blood cultures

Question 2

causes

Answer 2

Constipation
Hypoxia
Infection
Metabolic disturbance
Pain
Sleeplessness
Prescriptions
Hypothermia/pyrexia
Organ dysfunction (hepatic or renal impairment)
Nutrition
Environmental changes
Drugs (over the counter, illicit, alcohol and smoking)

Question 3

assessment of cognition

Answer 3

AMTS

Question 4

medical management of delirium

Answer 4

haloperidol or olanzapine
atypical antipsychotics like clozapine and quetiapine

Question 5

Predisposing factors include:

Answer 5

age > 65 years
background of dementia
significant injury e.g. hip fracture
frailty or multimorbidity
polypharmacy

Question 6

Factors favouring delirium over dementia

Answer 6

acute onset
impairment of consciousness
fluctuation of symptoms: worse at night, periods of normality
abnormal perception (e.g. illusions and hallucinations)
agitation, fear
delusions