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Year 3 - Ageing > Delirium > Flashcards

Delirium Flashcards

1
Q

What is delirium?

A

Acute, confusional state involving memory, speech and perception problems

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2
Q

Give 6 examples of common delirium triggers

A 
Dehydration
Alcoholism
Strong painkiller use
Change in meds/environment
Infection
MI
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3
Q

What neurotransmitter is mostly affected in delirium?

A

ACh

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4
Q

Give 4 examples of direct insults to the brain which may cause delirium

A

Drugs
Hypoxia
Hyponatraemia
Hypoglycaemia

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5
Q

What tools are used to assess delirium?

A

CAM

4AT

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6
Q

What are the components of the CAM score?

A 
Acute and fluctuating
AND
Inattention
WITH
Altered conscious 
OR
Disorganised thinking
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7
Q

What are the components of the 4AT?

A

Alertness
AMT4
Attention
Acute or fluctating

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8
Q

What is the 4AT marked out of?

A

12

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9
Q

Over which score on the 4AT is suggestive of delirium?

A

4

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10
Q

What is the AMT4 part of the 4AT?

A

Ask age; DOB; place; current year

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11
Q

How do you assess attention in the 4AT?

A

Months of the year backwards

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12
Q

How is delirium managed non-pharmacologically?

A

Calm, well lit, quiet side room

Familiar staff and belongings

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13
Q

How may delirium be pharmacologically managed?

A

Haloperidol max 5mg PO over 24 hours
Quetiapine 25mg PO
Benzodiazepines
Sedatives

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14
Q

What drug is given in delirium if caused by alcohol or benzodiazepine withdrawal?

A

Benzodiazepine

Or if there is a seizure

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15
Q

Which drug is known to worsen delirium?

A

Lorazepam

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16
Q

Which receptors does haloperidol work on?

A

D2

17
Q

In which scenarios would you give quetiapine over haloperidol in delirium?

A

Parkinson’s or Lewy Body Dementia

18
Q

Compare the onsets of delirium, dementia and depression

A

Delirium - acute
Depression - abrupt
Dementia - insidious

19
Q

Compare the courses of delirium, dementia and depression

A

Delirium - fluctuating
Dementia - progressive
Depression - worse in morning, reversible

20
Q

Compare the durations of delirium, dementia and depression

A

Delirium - hours to month
Dementia - months to years
Depression - >2 weeks

21
Q

Compare the activity levels of delirium, dementia and depression

A

Delirium - either sleepy and slow OR agitated and restless
Dementia - wandering, agitated
Depression - Withdrawn

22
Q

Compare the alertness of delirium, dementia and depression

A

Delirium - fluctuating

Normal in dementia and depression

23
Q

Compare the attention spans of delirium, dementia and depression

A

Delirium - impaired
Dementia - normal
Depression - poor concentration

24
Q

Which form of dementia presents with abnormal perception and hallucinations?

A

Lewy Body

25
Q

What are the most common hallucinations found in depression?

A

Third person derogatory auditory hallucinations

Year 3 - Ageing (9 decks)

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