Psychiatric Complications of Physical Disorders Flashcards
what is delirium?
impaired consciousness with intrusive abnormalities of perception and affect
what are the diagnostic factors of delirium?
impairment of consciousness disturbance of cognition psychomotor disturbance disturbance of sleep-wake cycle emotional disturbance
what are the general features of delirium?
rapid onset
transient and fluctuating course
lasts days to months depending on underlying cause
what drugs can cause delirium?
anticholinergic drugs anticonvulsants anti-parkinsonian drugs steroids cimetidine opiates sedatives alcohol & illicit drugs
withdrawal of what substances can cause delirium?
alcohol
sedatives (benzos)
barbiturates
illicit drugs
what metabolic conditions can cause delirium?
hypoxia hypoglycaemia compromised liver/kidney function deranged fluid/electrolyte balance hypo/hyperthyroidism hypopituitarism hypo/hyperparathyroidism porphyria carcinoid syndrome
what are traumatic causes of delirium?
intracranial / subdural bleed
accidental or surgical trauma
infections cannot cause delirium - true or false?
false
epilepsy can cause delirium - true or false?
true - can be ictal, interictal or postictal
neoplastic diseases do not cause delirium - true or false?
false
what vascular disorders cause delirium?
TIA thrombosis embolism migraine MI cardiac failure
what are the risk factors for someone developing delirium?
elderly dementia sensory deficits previous episode long or emergency surgery sensory extremes (hypo/hyperthermia) immobility social isolation new environment stress
what investigations should take place in delirium?
formal cognitive test urine analysis FBC, U&Es, LFTs thyroid function blood glucose CRP B12 and folate CXR MRI / CT brain consider EEG but be guided by emerging underlying cause
what are the principles of delirium management?
identify and treat the cause
manage environment and provide support
prescribe
review
what is the most common neuropsychiatric complication of strokes?
post stroke depression
