0521779407-C03 CUNY1086/Karliner 0 521 77940 7 June 4, 2007 20:54
390 Confusion & Delirium Congenital Qualitative Platelet Disorders■Easy distractibility
■History of predisposing medical cause–eg, infection (esp. respira-
tory or urinary), recent surgery, malnutrition, drug abuse, seizures,
trauma, endocrine disturbance, sensory deprivation; commonly
occurs in elderly hospitalized pts
tests
■Investigations needed to identify cause
■Laboratory studies: CBC, FBS, electrolytes, BUN, liver & thyroid func-
tion tests, urine toxicology screen, ABGs
■CXR to detect pulmonary infection
■ECG to detect recent MI or cardiac arrhythmia
■Cranial CT scan or MRI to detect structural cause
■Spinal tap to exclude infective cause (meningitis, encephalitis)
■EEG if seizure disorder is suspected
differential diagnosis
N/A
management
■Control symptoms of acute confusional state
specific therapy
■Treat underlying cause
follow-up
N/A
complications and prognosis
■Depends on underlying cause & on occurrence of any injuries while
pt is confusedCongenital Qualitative Platelet Disorders...................
MORTIMER PONCZ
history & physical
■Easy bruising, esp palpable bruises & scattered bruises of varying
age
■Menorrhagia or recurrent nosebleeds requiring red cell transfusions
■Hemorrhage after injury or surgery, esp late-onset hemorrhage
(1 wk later)
■Family history of a bleeding diathesis
■Consanguinity or originating from an in-bred population