Acute Confusion (OSCE)
From Wikiversity
History Taking for the Onset of Acute Confusion
Contents |
Major and Minor Criteria [edit]
- diagnosis of delirium requires both major plus any one minor criteria
- Can remember the criteria using the pneumonic AIDS:
Major [edit]
- Acute onset and fluctuating course
- Disorder of attention (inattention)
Minor [edit]
- Disorganized thinking
- Alterations in sensorium
Patient ID [edit]
CC [edit]
- need several iterations of the history, from several caregivers (may have large inter-observer differences in opinion)
HPI [edit]
- 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 [edit]
- benzodiazepines
- beta-blockers
- anticholinergics
PMHx [edit]
- trauma
- stroke
- CAD
- endocrinopathy
- kidney
- psych
FMHx [edit]
- dementia
- depression
SHx [edit]
- EtOH
- social support (caregiver stress), living arrangements
ROS [edit]
- sleep pattern
- visual changes
- hearing loss
- constipation
- incontinence
Other OSCE Modules [edit]
Acute Confusion - Acute Coronary Syndrome Orders - Anemia - Arterial Blood Gasses - Asthma - Blood Pressure - Chest pain - Chest XRay - CHF - Coma - COPD - Cranial Nerves - Diabetic History - Diabetic Foot - Dysphagia - EKGs - Gallbladder and Liver - Liver Disease - Gait and Balance - Headache - Hematemesis - Hypertension - Jugular Venous Pulses - Knee Exam - Lymph Nodes - Community Acquired Pneumonia - Parkinson Disease - Peripheral Arterial Insufficiency - Pneumonia Examination - Precordial Exam - STD's - Spleen - Swollen Leg Exam - Thyroid Exam - Upper vs Lower Motor Neuron Lesions - Urinary Incontinence
