The flashcards below were created by user
anders
on FreezingBlue Flashcards.
-
DDX Altered Mental Status:
- MOVEE SSTUPIDD
- Metabolic - B12, Thiamine def, hepatic encephalopathy, Wilson's Dz, niacin def
- Oxygen - hypoxemia, hypercarbia, anemia, decreased cerebral blood flow, sepsis, CO
- Vascular - stroke, hemorrhage, vasculitis, TTP, DIC
- Endocrine - hyper/hypoglycemia, hyper/hypothyroidism, high/low cortisol
- Electrolyte - low Na, hyper/hypocalcemia, hypermag, hypophos, abnl LFTs
- Seizures - post-ictal, status epilepticus, complex partial sz
- Structural - lesions with mass effect, hydrocephalus
- Tumor/Trauma/Temp - fever/hypothermia
- Uremia - also dialysis disequilibrium syndrome
- Psychiatric - ICU psychosis, "sun-downing"
- Infection - CNS, sepsis
- Drugs - intoxication or withdrawal
- Degenerative Dz - Alzheimer's, Parkinson's, Huntington's
-
AMS workup:
- Blood glucose
- CBC
- BMR, Mg, Phos
- LFT's
- UA, Utox
- ABG
- EKG, troponins
- Blood/Urine cx
- CXR
- consider non-con Head CT
- consider LP
-
AMS initial treatment:
- O2
- Thiamine 100mg IV, then D50 1amp
- Naloxone 0.4-1.2mg IV (if suspect opiod OD)
Further treatment based on lab/test results
-
Pseudotumor cerebri =
Idiopathic intracranial hypertension characterized by papilledema, normal imaging studies, and elevated opening pressure on lumbar puncture with normal CSF
Typically seen in young, obese females
-
Pseudotumor cerebri treatment:
- First line:
- Acetazolamide - carbonic anhydrase inhibitor, lowers intracranial pressure by reducing the production of CSF
or Furosemide
May resolve spontanesously, but risk of vision impairment/blindness if left untreated.
Surgical options: optic nerve fenestration, ventricular-peritoneal shunt
|
|