Delirium

Question 1

true/false - delirium is the most common complication of hospitalisation

Answer 1

true - 20-30% of inpatients

Question 2

4 common precursors to delirium

Answer 2

infection, dehydration, constipation and pain

Question 3

true/false - alcohol and drug withdrawal can induce delirium

Answer 3

true

Question 4

what is dementia

Answer 4

a chronic decline in memory or other cognitive function

Question 5

what is delirium

Answer 5

an acute onset of altered cognitive function, usually in relation to other illness

Question 6

give 4 types of dementia

Answer 6

alzheimers, lewy body, frontotemporal and vascular

Question 7

features of alzheimers

Answer 7

slow and insidious decline of memory, language and visuospatial. personality is preserved till late

Question 8

features of frontotemporal dementia

Answer 8

early personality changes and dysphasia and eating. memory and visuospatial preserved

Question 9

features of lewy body

Answer 9

parkinonisms, confusion and hallucinations, personality changes and falls

Question 10

features of vascular dementia

Answer 10

step-wise decline, often with other vascualr risk factors

Question 11

which type of dementia is likely to have the earliest onset

Answer 11

frontotemproal

Question 12

6 reversible cause of dementia

Answer 12

B12 defiency
HIV
syphillis
normal pressure hydrocephalus
depression

Question 13

true/false - hyperthyroidism can mimic dementia

Answer 13

false - hyPOthyroidism can mimic dementia

Question 14

what type of dementia rivastigimine used in

Answer 14

lewy body

Question 15

two drug classes that can be useful in dementia

Answer 15

cholinesterase inhibitors and antipsychotics

Question 16

assessment of dementia

Answer 16

MMSE, Hx, neuro exam, FBC, CT/MRI, CSF, PET scan

Question 17

supportive management for dementia

Answer 17

OT, social work, cognitive stimulation, get home, advanced care planning

Question 18

pharmacological managment of alzheimers

Answer 18

cholinesterase inhibitors and NMDA antagonists (memantine)

Question 19

presentation of delirium

Answer 19

altered sleep wake cycle
acute onset
altered cognition
hyper or hypoactive
altered psychomotor behaviour

Question 20

investigation of delirium

Answer 20

Hx, 4AT, TIME

Question 21

what is in a 4AT

Answer 21

Alertness out of 4
Age, DOB, place and year out of 2
Attention out of 2
Acute change out of 4

Question 22

non-pharmacological management of delirium

Answer 22

normalise sleep-wake cycle
avoid catheters
encourage mobility and self-care
re-orientate and reassure

Question 23

pharamacological treatments of delirium

Answer 23

medication review

quetiapine - antipsychotic

Question 24

what two particular drugs should you stop to treat delirium

Answer 24

anti-cholinergics and sedatives