Essential Facts on the Go: Internal Medicine (35 page)

NEUROLOGY

IX_1_a
Altered Mental Status

Differential Diagnosis

Toxins:

Prescription medications: anticholinergics, narcotics, benzodiazepines

Drugs of abuse: alcohol intoxication/withdrawal, opiates, ecstasy, cocaine, PCP, LSD, GHB

Poisons: inhalants, carbon monoxide, ethylene glycol, pesticides

Metabolic Disturbances:

Hypo/hyperglycemia, hypo/hypernatremia, hyper/hypocalcemia, hypermagnesemia, hypo/hyperthermia, hypoxemia, hypercarbia, hepatic encephalopathy, uremia, cardiogenic shock

Vitamin deficiencies: thiamine, niacin, folate, B
₁₂

Urinary retention

Dehydration, Malnutrition

Infection

CNS: meningitis, encephalitis, brain abscess

UTI/pyelonephritis, pneumonia, skin/soft tissue infection, osteomyelitis

Endocrine