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Other Psychiatric Presentations: Differences Btw (Delusions Fixed False…
Other Psychiatric Presentations:
Differences Btw
DELIRIUM
Disturbance of consciousness
with changes in alterness and increased distractibility
Acute onset -
change in baseline attention and awareness
Secondary
to neurocognitive diagnosis (outside headbox)
Due to: Consequence of other medical condition, substance intoxication/withdrawal or other etiologies
DISTINGUISH BTW:
Dementia, Delirium, depression
Aetiology:
Drugs ( intox/withdrawal)
Infection
Electrolyte & other metabolic Distrubances
Others ( I WATCH DEATH)
Infectious
Withdrawal
Trauma
CNS Pathology
Hypoxia
Deficiencies
Acute Vascular
Toxins ( Opidios, sedatives, aneasthetics (post op), NSAIDS)
Heavy Metals
Diagnosis
Disturbance of conciousness - Changes in memory, language, orientation
Time Course - Acute often with prodrome
Change in cognition --> Assess with CAM ( acute oset, inattention and Disrubed thinking), MMSE
Ix:
Full work up ( Bloods and urine)
Chest Xray ( if suspect infectious cause)
Tx:
Treat Cause
Symptom Management
Antipsychotis: Haloperidol ( or olanzspine, risperidone)
Benzodiazapines in EtOH withdrawal
Illusions
misinterpretation of a true sensation
Auditory
Tactile
Optical
Hallucinations
Perception in stimulus absence
Optical
Tactile
Auditory
Gustatory
Command
Delusions
Fixed False belief despite being presented with evidence to the contrary
Religiosity
Unique relationship with God, prominant person
Erotomanic
Belief that a famous person in in love with you
Grandiose
Special,amazing
Jealous
Partner being unfaithful
Persecutory
Groups/person is conspiring against them
Somatic
Body is strange/not functioning properly
DELIRIUM TREMENS
EtOH Withdrawl Delirium
High SNS - Sweaty, Tachy
Hand Tremor
Insomnia
Psycho-motor agitation
Anxiety
N/V
Toxic- clonic Seizures
Hallucinations
Persecutory delusions
