Which of the following is considered under acute neuropsychiatric complications of AIDS?

AIIMS Bhopal NO - 2018 (Shift-1st)

Medical & Surgical Nursing

Easy

Appeared in: AIIMS Bhopal NO - 2018 (Shift-1st)

Explanation

Delirium is an acute neuropsychiatric syndrome defined by its rapid onset over hours to days.
It presents with fluctuating disturbances in attention, awareness, and overall cognition.
In patients with AIDS, delirium is a critical finding that often points to a new, underlying medical issue like an opportunistic infection, metabolic problem, or drug toxicity, requiring immediate investigation.

Option B: An organic personality disorder involves a marked, enduring change from an individual's previous personality. This is a chronic condition, not an acute complication.
Option C: Organic hallucinosis is characterized by persistent or recurrent hallucinations in a clear state of consciousness. This is typically a subacute or chronic condition, unlike the global cognitive disruption seen in acute delirium.
Option D: AIDS dementia, now more commonly called HIV-Associated Neurocognitive Disorder (HAND), is a subacute to chronic condition. It is characterized by a slow, progressive decline in cognitive function that occurs over weeks, months, or years.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Neuropsychiatric Complications of AIDS as background academic context rather than a clinical decision trigger.
For a nurse, distinguishing between acute delirium and chronic dementia is a critical skill. Delirium in a patient with AIDS is a medical emergency that signals an urgent, often reversible, underlying problem.
Prompt recognition and reporting of delirium can lead to timely treatment of its cause (e.g., infection, hypoxia, electrolyte imbalance), potentially preventing permanent brain damage or death.
What if? If the patient presented with a 6-month history of increasing forgetfulness and difficulty concentrating, but was alert and oriented without fluctuation, the primary suspicion would shift from acute delirium to a chronic process like AIDS dementia (HAND).

How to Approach the Question

First, identify the key term in the question stem, which is 'acute'.
Define 'acute' in a clinical context: a condition with a sudden onset (hours to days), short duration, and often a fluctuating course.
Next, evaluate each option based on this definition.
Recall or deduce the typical time course for each condition. Delirium is a classic example of an acute confusional state.
Recognize that dementia, personality disorders, and chronic hallucinosis are, by definition, long-term (subacute or chronic) conditions.
Select the option that aligns with the definition of an 'acute' complication.

Concept Tested & Keywords

QtrjhGZPs5_JyKMikBxZSA

E6 Kaplan Sadock's Synopsis of Psychiatry-2022 (pp 1-3768 of 3768) pp. 835-837, 792-794

E6 Medicine Harrison 22e Part 1 p. 1648-1650