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Year 3 - Gerries > Capsule cases > Flashcards

Capsule cases Flashcards

1
Q

Features of delirium

A

Not eating
Sleeping constantly
No lucid conversations

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2
Q

What are the two forms of delirium

A

Hyperactive
Hypoactive
Mixed

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3
Q

What functions of the brain is affected in delirium?

A 
Disturbance of brain leading to:
Changes in altertness
Attention
Perception (incl. paranoia)
Cognitive function
Behaviour
Physical function
Sleep cycle
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4
Q

What proportion of patients on the wards have delirium?

A

1/5 on general wards

1/3 on gerries wards

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5
Q

Pathophysiology/what we know

A

No idea but EEG show cortical slowing

Might be due to inflammation, chronic stress, neurotransmission

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6
Q

Predisposing conditions for delirium?

A 
Visual impairment
Hearing impairment 
Dehydration
Pain
Age 
Decreased oral intake
Coexisting medical conditions
Drugs
Cognitive status
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7
Q

What might precipitate a delirium?

A 
Pain
New environment
Anaesthesia
Dehydration
Disturbed sleep
Electrolyte disturbances
Infection
Surgery
Cardioresp/neuro?
Constipation
Endocrine/metabolic thigs
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8
Q

History

A 
Collateral hx
Is the confusion is a new phenomenon?
Hx of incontinence
Full drug hx?
Use of glasses/hearing aids
SH
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9
Q

Bedside examinations

A 
GCS
Temp
Signs of infection
Full system examination, including PR
Pressure sores and pain 
AMTS or MMSE or MOCA
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10
Q

Investigations for acute delirium

A 
Pulse oximetry
BP
Urinalysis 
FBC
Renal profile
Calcium
LFTs
Glucose
Blood cultures
ABGs
ECG
CXR
CRP
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11
Q

What do you test lumbar puncture for?

A

Protein
Glucose (plasma and CSF)
WCC
Gram stain

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12
Q

Headache plus delirium - what tests do you do?

A

CT head

LP

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13
Q

What is the difference in appearance, WCC, glucose and protein of CSF between bacteria and viruses?

A

Bacterial - cloudy
Viral - normal

Bacterial - neutrophils high
Viral - lymphocytes high

Protein high in bacteria
Normal or high in viral

Glucose low in bacteria
Normal or low in viral

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14
Q

Characteristic features of Frontotemporal dementia

A

Disinhibition

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15
Q

Characteristic features of vascular dementia

A

Focal neurological signs

stepwise deterioration

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16
Q

Characteristic features of Alzheimers dementia

A

Difficulty naming recent things

17
Q

Three types of rapidly progressive dementia

A

Creutzfeld-Jakob disease
Lewy body dementia
Frontal temporal dementia

18
Q

Three types of fixed impairment demenita

A

Traumatic brain injury
Anoxic brain injury
Post infection

19
Q

Progressive dementia

A

Alzheimers

Vascular

20
Q

What two investigations must you do to rule out reversible causes of dementia?

A

TFTs - hypothyroidism can cause myxoedema coma
Vit B12
CT head

21
Q

What would you see in CSF if the pt has GBS?

A

Protein is high

Everything else normal

22
Q

What would you see in CSF if the pt has GBS?

A

Protein is high

Everything else normal

23
Q

What would you see in CSF if the pt has SAH ?

A

Blood stained CSF

Everything else normal but protein may be high

24
Q

A CT scan looks like there’s no gyri. What might be the issue?

A

Bilateral subdurals - subacute

Isodense

25
Q

What would you see on a CT in frontotemporal dementia?

A

Abnormal volume in frontotemporal lobe

26
Q

Toxins released by clostridium difficile

A

A and B

27
Q

What causes c difficle exposure in the gut?

A

Cephalosporin antibiotics (more than:)
Ampicillins
Ciprofloxacin

28
Q

Rx for clos.dif.

A 
Old age
Immunosuppresion
Abx exposure
Long hospitalisation
PPI
Manipulation of GIT
29
Q

Symptoms of clostridium diffficile infection

A

Mild to moderate Diarrhoea
CD Collitis
Pseudomembranous colitis

30
Q

Complications for pseudomembranous colitis

A

Toxic megacolon
Perforatoin
Sepsis

31
Q

Management for clos.dif.

A

Stop Abx/PPI
Metronidazole
Vancomycin

32
Q

GCS scoring

A

Eyes

1-4; none, to pressure, to sound, spontaneous

Verbal 1-5; none, sounds, words, confused, orientated

Motor - 1-6; none, extension, flexion, withdraws to pain, localises to pain, to command

Year 3 - Gerries (1 decks)

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