Delirium Flashcards
1
Q
Clinical features of delirium
A
Acute Fluctuating -awareness -memory impairment -attention -disordered thinking \+\- hallucinations persecutory delusions sleep walk cycle disturbance
2
Q
Epidemiology of delirium
A
Most common complication in elderly hospital admissions
Up to 50% of elderly post op
30% of medical in patients
1/3 die that admission
3
Q
Causes of delirium
A
Infection + sepsis
Anoxia
Metabolic and endocrine imbalance
Nutritional-> thiamine, B12, folic acid, niacin
Drugs-> anticholinergics, benzo’s, opiates, anti-Parkinson’s, steroids
4
Q
Risk factors for delirium
A
Old age >65 Dementia Frailty Severe illness Multiple diseases Visual impairment Deafness Poly pharmacy Alcohol excess Renal impairment Malnutrition
5
Q
Precipitants of delirium
A
Infections Constipation Electrolyte disturbance Drugs Alcohol withdrawal Neurological disorder Hypoxia Pain Sleep deprivation Surgery
6
Q
Diagnosis of delirium
A
History and full examination Collateral history Alcohol? Sequential mental testing -> change from normal
7
Q
Differentials for delirium
A
Lewy body dementia Progression of vascular dementia Decompensation of dementia Pure disorder of alertness Disorder of communication Post ictal confusion Primary psych
8
Q
Management of dementia
A
-> identify and treat cause Review medications Relieve symptoms Review legal status Supportive care: Minimise antipsychotics/depressants Good lighting, minimal noise Regular orientation to place and time Sensory aids Family members Low does haloperidol
9
Q
Definition of delirium
A
Acute, generalised impairment of brain function
Final common pathway of disturbed homeostasis
