Delirium Flashcards
1
Q
What is delirium?
A
Acute confusional state which often affects elderly patients in hospital
2
Q
What are the 3 types of delirium?
A
Hyperactive
Hypoactive
Mixed
3
Q
What are risk factors for delirium?
A
- Age > 65
- Background of dementia
- Significant injury e.g. hip fracture
- Frailty/Multimorbidity
- Polypharmacy
4
Q
What are causes of delirium?
A
Pain
Infection - particularly UTI
Nutrition - alcohol withdrawal, metabolic dysfunction
Constipation
Hydration - urinary retention
Medication - opioids, benzo, CCB, TCA, anti-psychotics
Environment
5
Q
How does delirium present?
A
- Acute changes
- Altered cognitive function (disorientation, memory impairment, confusion)
- Inattention
- Disorganised thinking
- Altered perception
- Altered social behaviour
- Altered consciousness
6
Q
What are signs of hyperactive delirium?
A
- Increases sensitivity to surroundings
- Agitation
- Sleep disturbance
- Restlessness
- Hypervigilance
7
Q
What are signs of hypoactive delirium?
A
- Lethargy
- Reduced mobility/movement
- Anhedonia
- Reduced appetite
- Withdrawn
8
Q
What criteria can be used to confirm delirium?
A
CAM Criteria (confusion, inattention, disordered thinking, altered consciousness)
4-AT test (alertness, cognition, attention, presence of acute changes)
DSM-5 criteria
9
Q
How is delirium managed?
A
- Same day admission generally needed
- Targeted investigations to find out cause e.g. urinalysis, FBC, Folate/B12, HBa1c, Chest X-ray
