delirum n dementia pearls

Question 1

delirium/ etiologies

Answer 1

Alm^{ost a}ny illne^ss

Question 2

delirium/ need to identify the cause?

Answer 2

yes!! Always!!

Question 3

a^cutely ill + older pts+a^cute deterioration in me^{ntal s}tatus/

suffer from….

Answer 3

delirium.

Question 4

px: complete resolution of delirium?

Answer 4

Only a small % of pts with delirium have com^{plete re}sol^ution of sx with tx of the underlying di_sease and return home

Question 5

common cause of delirium?

Particularly common in …?

What to do?

Answer 5

=>pa_rticul^arly c_om^mon in o_lder pt^s/

c^om_mon ca_use of d_elirium =R_{x to}xicity;

even at _ther_apeu^tic doses/

=>Review all Rx especially psyc^hoactive o^nes.

Question 6

what to do x EVERY pt on admission?

Answer 6

an alcohol history

Question 7

delirium/If a clinical syndrome suggestive of alcohol withdrawal occurs in a patient who denied alcohol use; what to do next?

Answer 7

seek info from ot^her so^urces

Question 8

alcoholic patient/ alcohol withdrawal/

successful management?

Answer 8

Car_eful moni^toring

pr^ompt pat^ient-specific adju^stment of be^nzodia^zepine dose

Question 9

possible other presenting or initial sx

for pt w Alz. dz?

Answer 9

mem_{ory loss} may not be the presenting symptom/

be_havioral or pe^rsonal^ity cha^nges;

func_tional impa^irments;

socia_{l wit}hdrawal; or

la_nguage distu^rbances

Question 10

subtl^{e be}havior_{al chan}ges in ol^der patients./

alw consider… in the diff?

Answer 10

AD

Question 11

high clinical suspicion of dementia./

which tests to do?

Answer 11

in offi_{ce te}sting => if negative

=>Neu_ropsychi^atric tes^ting

Question 12

pt w dementia + parkinsonian features + a fluctuating course; + visual hallucinations/ think

Answer 12

Demen_{tia with} Lew^{y Bo}dies (DLB)