View source for Archive:Acute confusion

'''History Taking for the Onset of Acute Confusion'''
==Major and Minor Criteria==
*diagnosis of delirium requires both major plus any one minor criteria
*Can remember the criteria using the pneumonic AIDS:

===Major===
*'''Acute''' onset and fluctuating course
*Disorder of attention ('''inattention''')

===Minor===
*'''Disorganized''' thinking
*Alterations in '''sensorium'''

==Patient ID==

==CC==
* need several iterations of the history, from several caregivers (may have large inter-observer differences in opinion)

==HPI==
*onset
**acute (<2-3 months)
**chronic (> 3 months represents a dementing state)
*progress
**gradual decline, static, rate of fluctuation
*palliating
*precipitating
*quality
**AIDS
**altered LOC
**disorientation
**memory
**psychomotor agitation/retardation
**altered sleep-wake cycle
*severity
**ADL → getting out of bed, using the bathroom, dressing, ambulation
**IADL → cooking, laundry, shopping, banking, paying bills, driving
**safety concerns
**cognitive function (MMSE)
*symptoms
**behaviour changes - agitation
**SAH → thunderclap headache
*stroke → aphasia, paralysis
*UTI → dysuria
*pneumonia → cyanosis, cough, sputum, fever

==Medications==
*benzodiazepines
*beta-blockers
*anticholinergics

==PMHx==
*trauma
*stroke
*CAD
*endocrinopathy
*kidney
*psych

==FMHx==
*dementia
*depression

==SHx==
*EtOH
*social support (caregiver stress), living arrangements

==ROS==
*sleep pattern
*visual changes
*hearing loss
*constipation
*incontinence

==Other OSCE Modules==
{{OSCE2}}
[[Category:OSCE]]
[[Category:Geriatric medicine]]