Mehl. medication induced delirium + tiesiog delirium 03-14 (1) Flashcards
Reye syndrome. CP?
Acute encephalopathy and hepatic dysfunction caused by giving aspirin in the setting of a viral illness and/or fever.
Reye syndrome. cause with what drug?
aspirin in the setting of a viral illness and/or fever.
Reye syndrome. avoid aspirin under what age?
Aspirin should be avoided under age 12, and some sources say avoid in teens for that matter.
Reye syndrome. Mechanism is obscure and thought to be related to impairment of b-oxidation.
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Anti-cholinergic delirium. CP?
Anti-cholinergic medications can cause confusion and a delirium-like presentation
Anti-cholinergic delirium. who have incr risk?
Children have incr. susceptibility.
Anti-cholinergic delirium.
Can mention a kid was given an over-the-counter medication and now has low-grade fever and confusion.
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Anti-cholinergic delirium. what CP suggest over Reye?
Details such as flushed, dry, warm skin, or enlarged pupils, suggest anti- cholinergic delirium over Reye.
Anti-cholinergic delirium.
Can be confused with Reye syndrome if they just say “over-the-counter” med.
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Anti-cholinergic delirium. What drug group is notoriously ant-cholinergic?
1st-gen H1-blockers (i.e., diphenhydramine) are notoriously anti-cholinergic.
Dextromethorphan. CP?
Can cause delirium and psychosis in children when taken in excessive amount.
Dextromethorphan. used for what?
An opioid that is an anti-tussive (cough suppressant).
Delirium. Hypercalcemic crisis. definition? in what pathologies?
Refers to cognitive dysfunction / a delirium-like state in the setting of severe hypercalcemia, often due to malignancy or primary hyperparathyroidism.
Delirium. Hypercalcemic crisis. with what diuretics?
I’ve also seen this once in a patient on a thiazide (can cause hypercalcemia).
Delirium. Hypercalcemic crisis.
USMLE wants you to know that high calcium, as well as any sodium disturbance, can cause delirium.
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Delirium. Hypercalcemic crisis. First line Tx?
First step on USMLE for Tx of hypercalcemia is normal saline.
Delirium. Hypercalcemic crisis. after normal saline, next step Mx?
After normal saline, USMLE wants bisphosphonate therapy (I’ve seen pamidronate listed on NBME).
Delirium. Hypercalcemic crisis.
I’ve never seen calcitonin or loop diuretics as correct answers for hypercalcemia Tx. They’re always wrong.
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Delirium. definition?
Acute disturbance in attention and cognition, usually over hours to days.
Acute disturbance in attention and cognition, usually over hours to days.?
Delirium.
Delirium. Most commonly presents as hyperactive delirium, which is where the patient appears confused, restless, agitated, and combative.
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Delirium. can present also as?
Can also present as hypoactive delirium, where the patient mute, lethargic, or slow to respond to stimuli.
Delirium. important causes?
Important causes are infection, electrolyte disturbance (e.g., hypercalcemic crisis), medications (especially first-gen H1 blockers like diphenhydramine), and metabolic causes (e.g., hypercarbia in COPD exacerbation)
