GP clinic 3

Question 1

Differential diagnosis of confusion

Answer 1

delerium, dementia, think about whether it is acute vs chronic. Delirium is an acute confusional state

Question 2

Summarise the causes of delerium

Answer 2

infective
metabolic - uraemia, hyponatraemia, hyper/hypocalcaemia
precipitating factors: recent admission, constipation secondary to painkillers

Question 3

investigations to consider for delirium

Answer 3

bedside - urine dipstick, ECG
bloods - FBC, WCC, VBG, U&Es, LFTs, TFTs, calcium, folate, B12, glucose
imaging - chest X ray
stool chart
toxicology

Question 4

investigations show hyponatraemia, CXR shows suspicious lung nodule in left upper zone and all other tests normal. what is the cause of her delirium

Answer 4

small cell lung cancer which can lead to SIADH and hyponatraemia which can then present as confusion. Legionella can also cause hyponatraemia

Question 5

causes of bronchiectasis

Answer 5

congential, post infection, obstruction, aspiration,