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Hypertension and Altered Mental Status (AMS) - Differential Diagnosis Framework

Hypertension:
 • Hypertensive emergency
 • Hypertensive encephalopathy
Status (AMS) - Differential ... Diagnosis Framework ... • Cushing’s syndrome ... NCSE • Delirium/agitation ... #Diagnosis #causes
Posterior Reversible Encephalopathy Syndrome (PRES) - Diagnosis
Clinical Features:
 • Altered mental status (Either lethargy, confusion, or
Posterior Reversible Encephalopathy ... Syndrome (PRES) ... confusion, or agitation ... Posterior #Reversible #Encephalopathy ... #Syndrome #Diagnosis
Causes of Encephalopathy - Differential Diagnosis Algorithm
Hyperacute:
 - Primary Neurologic: Vascular (IS, ICH), Seizure, Migraine, Trauma
- Differential ... Diagnosis Algorithm ... Vascular (IS, ICH ... paraneoplastic syndromes ... #Differential #
Pain, Agitation, and Delirium (PAD) in the ICU
Addressing the ICU Triad (PAD) can be accomplished through
Pain, Agitation, ... Propofol infusion syndrome ... bradycardia • Ketamine ... #CriticalCare # ... diagnosis #management
Checklist for Treatment of Delirium in the ICU 

Remove causative factors 
 - 
Exclude hypoglycemia if
Delirium in the ICU ... If Wernicke's encephalopathy ... treatment for hepatic encephalopathy ... severe nocturnal agitation ... #CriticalCare
Serotonin Syndrome - THINK: FAST
 - FAST onset
 - FAST movements (agitation, akathisia, HYPERreflexia)
 - FAST
Serotonin Syndrome ... FAST movements (agitation ... Neuroleptic Malignant Syndrome ... #Diagnosis #Toxicology ... #Comparison #Differentiate
Checklist for Evaluation of New-Onset Delirium in the ICU

Initial assessment 
 - 
Vital signs, neuro exam
Delirium in the ICU ... - CBC with differential ... if hypercapneic encephalopathy ... #CriticalCare # ... Diagnosis
When trying to differentiate between the two conditions think “FAST” with Serotonin Syndrome and “SLOW” with
When trying to differentiate ... with Serotonin Syndrome ... Serotonin Syndrome ... FAST movements (agitation ... resolution #Diagnosis
Acute Altered Mental Status - Rapid Response Management

1) Ask while en route: vitals, hyper/hypoactive, POC glucose,
• Hyperactive (Agitation ... Hypoactive 3) Examine ... status #Management #criticalcare ... #encephalopathy ... #differential #
Patterns of Diseases on MRI FLAIR - Differential Diagnosis
ADEM, Adreno-leukodystrophy, CADASIL, CNS, Lymphoma, High-Grade Glioma, HIV
on MRI FLAIR - Differential ... Diagnosis ADEM ... High-Grade Glioma, HIV Encephalopathy ... Disease, Susac Syndrome ... Diseases #MRI #Differential