Delirium Flashcards
true/false - delirium is the most common complication of hospitalisation
true - 20-30% of inpatients
4 common precursors to delirium
infection, dehydration, constipation and pain
true/false - alcohol and drug withdrawal can induce delirium
true
what is dementia
a chronic decline in memory or other cognitive function
what is delirium
an acute onset of altered cognitive function, usually in relation to other illness
give 4 types of dementia
alzheimers, lewy body, frontotemporal and vascular
features of alzheimers
slow and insidious decline of memory, language and visuospatial. personality is preserved till late
features of frontotemporal dementia
early personality changes and dysphasia and eating. memory and visuospatial preserved
features of lewy body
parkinonisms, confusion and hallucinations, personality changes and falls
features of vascular dementia
step-wise decline, often with other vascualr risk factors
which type of dementia is likely to have the earliest onset
frontotemproal
6 reversible cause of dementia
B12 defiency HIV syphillis normal pressure hydrocephalus depression
true/false - hyperthyroidism can mimic dementia
false - hyPOthyroidism can mimic dementia
what type of dementia rivastigimine used in
lewy body
two drug classes that can be useful in dementia
cholinesterase inhibitors and antipsychotics
assessment of dementia
MMSE, Hx, neuro exam, FBC, CT/MRI, CSF, PET scan
supportive management for dementia
OT, social work, cognitive stimulation, get home, advanced care planning
pharmacological managment of alzheimers
cholinesterase inhibitors and NMDA antagonists (memantine)
presentation of delirium
altered sleep wake cycle acute onset altered cognition hyper or hypoactive altered psychomotor behaviour
investigation of delirium
Hx, 4AT, TIME
what is in a 4AT
Alertness out of 4
Age, DOB, place and year out of 2
Attention out of 2
Acute change out of 4
non-pharmacological management of delirium
normalise sleep-wake cycle
avoid catheters
encourage mobility and self-care
re-orientate and reassure
pharamacological treatments of delirium
medication review
quetiapine - antipsychotic
what two particular drugs should you stop to treat delirium
anti-cholinergics and sedatives
