Confusion laboratory findings

Several laboratory tests are available for evaluating confusion. It is a physician’s role to choose the most useful test based upon the history of the person. For example, a patient presenting with confusion, severe neck stiffness, headaches, and fever should be evaluated for infective foci.

• A large number of tests are needed in patients that present with confusion. Most of the tests are to determine the cause of confusion. A careful history can reduce the burden of unnecessary tests.

• Routine blood tests include a CBC to assess the general condition of the patient.

• Serum creatinine, glucose, calcium, electrolytes.

• Blood for toxins and drugs.

• Urine analysis and culture.

• Blood culture if infectious cause has to be evaluated.

• Blood gas analysis if any metabolic derangements are suspected.

• Vitamin assays and cholesterol levels may indicate nutritional status.

• Renal function tests and liver function tests are useful if they are the cause of confusion.

• Assessments of hormone levels may be useful especially thyroid.

• In cases of brain infections lumbar puncture is done and cerebrospinal fluid is evaluated.

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