Altered mental status

magzfellowship's version from 2015-10-16 07:36

Section 1

Question Answer
what's acute brain syndrome?delirium = global cognitive impairment with clouding of consciousness and fluctuating conscious state
common causes for deliriuminfection, drugs, withdrawal, metabolic disturbance, AMI, stroke, SDH
what is dementia? disturbance of cognitive and higher cortical functions, including memory loss→behavioural/social issues
causes of dementia? Alzheimer’s disease – 65-70% - amyloid β plaques & neurofibrillary tangles in cortex. Vascular dementia 15%. Dementia with Lewy bodies – 10%. Frontotemporal dementia (Pick’s disease) – 10% - behavioural changes, apathy, aphasia
what's the scoring system for dementia? MMSE < 24

Section 2

Question Answer
Define coma? Unresponsive and unrousable state of unconsciousness. GCS<8
unusual treatable causes for comanon-convulsive status epilepticus, toxins, NMS, serotonin syndrome, NAI, thyroid storm, myxedema coma, hypercapnic narcosis, hepatic/renal encephalopathy, TTP
DD for coma INTRACRANIAL: CVA, SAH, SDH, extradural haemorrhage, large corticol infarct, tumour, meningitis, encephalitis, DAI, post-ictal; EXTRACRANIAL: CARDIAC: hypotension, H/T, arrhythmia; METABOLIC: hyper/po - glycaemia, natraemia, calcaemia, Mg, thermia; Wernicke's; TOXIC: sedatives, hypnotics, TCAD, antidepressants, alcohol, opioids; HYSTERICS
what's in the coma cocktail? thiamine 100mg IV, glucose 50ml 50%, naloxone 400ug-2g