Delirium

Question 1

Define delirium

Answer 1

Disturbance in attention with change in cognition, developing over a short period with a fluctuating course

Question 2

Compare the onset of delirium with dementia

Answer 2

Dementia: chronic, slow
Delirium: acute, sudden

Question 3

Compare the course of delirium with dementia

Answer 3

Dementia: progressive, irreversible
Delirium: fluctuating, reversible

Question 4

List some symptoms of delirium

Answer 4

Agitation, restless (hyperactive)
Slow, sleepy (hypoactive)
Fluctuating emotions
Impaired attention

Question 5

List predisposing factors for getting delirium

Answer 5

Old age
Sensory impairment
Polypharmacy
Dementia, depression
Alcohol dependency
Malnutrition

Question 6

Hypoactive delirium has twice the mortality of hyperactive delirium. True/False?

Answer 6

True

Question 7

Describe the 4AT tool for diagnosing delirium

Answer 7

Alertness
AMT4 (age, dob, place, year)
Attention
Fluctuating course
Score of 2 = delirium

Question 8

State the 4 hallmark features of delirium, described by the confusion assessment method (CAM)

Answer 8

Inattention
Fluctuating course
Disorganised thinking
Altered consciousness

Question 9

How is delirium mainly treated?

Answer 9

Support, advice, reassurance, education

Symptom control

Question 10

Which medication may be used for delirium?

Answer 10

Haliperidol low-dose oral
Quetiapine if Parkinson’s
Benzodiazepine if alcohol withdrawal