Mental Status & Toxicology (Exam #3) Flashcards
(46 cards)
What mental status finding involves NOT fully alert, drifts to sleep, loses train of thought?
Lethargy/Somnolent
What mental status finding involves needing persistent stimulation, confusion?
Obtunded
What mental status finding involves needing vigorous and persistent stimulation, moan/mumble?
Stuporous/Semicomatose
What mental status finding involves unarousable unresponsiveness?
Coma
What are the three components of GCS?
- Eye movement
- Motor response
- Verbal response
What posture involves flexor response?
Decorticate
What posture involves extensor posturing?
Decerebrate
Where is the lesion located for Decorticate posturing? Where is the lesion located for Decerebrate posturing? Which is WORSE?
- Decorticate: cortex/upper midbrain
- Decerebrate = WORSE: brainstem
If a lesion is located in the cortex/upper midbrain, what posturing may be seen?
Decorticate
If a lesion is located in the brainstem, what posturing may be seen?
Decerebrate
What four conditions can differentiate Delirium from Dementia?
- Short period of time
- Fluctuates
- Abnormal vital signs and PE
- GLOBAL neuro findings
What is the primary RF associated with Delirium? What are three examples?
Underlying brain disease (Dementia, PD, CVA)
What is the mnemonic associated with the etiologies of AMS, and what does each letter stand for?
This is trash, I apologize
AEIOU TIPS
- Alcohol
- Epilepsy, endocrine
- Infection
- O2, opioids
- Uremia
- Trauma, temp., toxins
- Insulin
- Psychosis
- Stroke, shock
What two PE findings may be indicative of AMS?
- Pupil size
- Skin temp.
What three meds can ALWAYS be started with AMS?
- Thiamine
- Dextrose
- Naloxone
What two drug classes should be avoided with AMS? What else should be avoided/used as last resort?
Avoid restraints = last resort
- Benzos
- AChE-I
What drug can be considered ONLY if the AMS is severe and the patient is a harm to others?
Psychotropic drugs (Haldol)
What two developments are seen with physiologic EXCITATION?
- CNS stimulation
- Increase in BP, HR, RR, temp.
What four drug classes are responsible for physiologic EXCITATION?
- Anticholinergics
- Sympathomimetics
- Hallucinogens
- Drug withdrawal
What two developments are seen with physiologic DEPRESSION?
- Depressed mental status
- Decrease in BP, HR, RR, temp.
What five drug classes are responsible for physiologic DEPRESSION?
- Ethanol, methanol, ethylene glycol
- Sedative-Hypnotics
- Opioids
- Cholinergics
- Sympatholytics
Do Anticholinergics cause physiologic excitation or depression?
Physiologic EXCITATION
Do Sympathomimetics cause physiologic excitation or depression?
Physiologic EXCITATION
Do Hallucinogens cause physiologic excitation or depression?
Physiologic EXCITATION
