![]() This memory device, as well as the rest of the Tiny Tips, have been made into flashcards that can be downloaded and used as outlined on the Boring Cards page. Within minutes, a diligent emergency physician must narrow the differential to a manageable number of possible diagnoses and initiate appropriate treatment. Specifically, hypertensive encephalopathy and post-ictal state do not have a place (although they can lead to or be the result of some of the other things on the list). While it’s a very good acronym, there are unfortunately a few things it doesn’t mention that are important to consider. Intracranial causes can include… while extracranial causes can include… Based on this patient’s presentation, I think x or y is the most likely but can’t forget about a, b or c because missing them could lead to a disastrous outcome.Īnd they’ll think you’re all clever and organized and stuff. Although lithium poisoning can cause altered mental status and central nervous system symptoms such as delirium, tremor, and seizure, it is typically associated with gastrointestinal symptoms such as nausea, vomiting, and diarrhea. Medical students, the next time an attending asks you for a differential of altered mental status, bust out something like this:Īltered mental status can be caused by intracranial and extracranial pathology. It is important to recognize the early signs of altered mental status, identify the underlying cause, and to provide the appropriate care to reduce patient morbidity and mortality. Not only do the letters have fairly intuitive meaning, but they also provide a structural approach with IS IT representing intracranial causes while MEAT represents extracranial causes. Altered mental status is a common presentation. IS IT MEAT is a common mnemonic for this presentation and the best one that I have come across (thanks to Nadim Lalani from for teaching it to me and George Farjou for the quick comments to improve it). Having a solid approach helps provide structure to the workup of a difficult group of patients. When a patient presents to the emergency department (ED) with altered mental status, three broad categories of diagnosis should be considered: delirium, coma, and dementia. ![]() Altered mental status is a frequent presentation with a very broad differential.
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