Psychiatric Complications of physical disease Flashcards
What are the features of delirium?
impairment of consciousness; disturbance of cognition; psychomotor disturbance; sleep-wake cycle disturbance; emotional disturbance; transient and fluctuating; rapid onset
What may be seen in impairment of consciousness with delirium?
clouding; drowsiness; coma
What are the features of cognition disturbance in delirium?
disorientation in time and place; impaired memory and attetnion;visual hallucinations; delusions
What is hypo-delirium commonly misdiagnosed as?
depression
What are the common causes of delirium?
drugs; withdrawal; metabolic; infecion; head trauma; epilepsy; neoplasms; vascular disorders
What drugs commonly cause delrium?
anticholinergics; anticonvulsants and antiparkinsonian drugs
Is delirium still diagnosable if no cause is found?
yes- clinical diagnosis
What are the risk factors for developing delirium?
age; cognitive deficit; prev eps; postop; extremes in sensory experience; immobility; social isolation; new environment; stress
What is seen on EEG with delirium?
diffuse background slow wave activity
What cognitive tests are used to diagnose delirium?
MMSE; 4AT
What is the management of delirium?
find cause; reality orientation; correct sensory impairment; bright sideroom wihout unnecessary equipment; ensure basic needs met
What should be done after delirium has resolved?
repeat cognitive testing to avoid misdiagnosis of dementia
What drugs are used in delirium?
antipsycotics- haloperidol
What drug is used in delirium if patient is intolerant of haloperidol or has parkinsons or lew body or neuroleptic sensitivity?
lorazepam
What is delirium a risk factor for?
devloping persistent cognitive impairment and depression
