#1 Dementia and Delirium Flashcards
Aetiology of Dementia ?
1.) Largely unknown cause
2.) Alzheimers disease accounts for 50-70% cases
Dementia definition ?
1.) Progressive or persistent loss of intellectual function
2.) Decrease in memory, orientation, language etc.
3.) Major neurogenerative condition
Pathophysiology Dementia ?
1.) Damage and loss of neurons
2.) Neurofibrillary tangles and plaques
3.) Native Protein build up on the brain, the cells cannot communicate and therefore brain GM shrinks as neurons are not firing effectively.
4.) Neurotransmitter decrease (choline acetytransferase)
Clinical Manifestations Dementia ?
1.) Disturbances in memory, language, perception, motor skills, personality change and mood changes.
Dementia Diagnosis ?
1.) Diagnosis based on history, brain imaging (MRI) and mental status exams.
Dementia Treatment ?
1.) Support and relief for behavioural disturbances
2.) meds such as anti-psychotics, anti-depressants (tricyclics, SSRI’s, MAOI’s)
Delirium aetiology
dehydration, meds (illegal drugs, toxicity, pain killers), sepsis, hypoxia, hypoglycaemia, kidney and liver dysfunction, Post GA
How do you characterise Delirium
Loss of orientation, intense autonomic systemic hyperactivity or hypoactivity
Pathophysiology of Delirium
1.) Unknown
2.) Drugs like cocaine & amphetamines increase release of neurotransmitters
Clinical Manifestations of delirium
1.) Hyperactive:
- Agitation and aggression
- Restlessness
- Fast speech, hallucinations
- Inability to obey commands
- Altered LOC
2.) Hypoactive
- Slurred Speech
- Motor retardation
- Sedation
- Lethargy
Treatment of Delirium
1.) Treat the cause
2.) Keep patient and staff, family safe
3.) vitals, FNO
4.) Meds: Anti-psychotics, sedation (Benzos)
Delirium Risk factors
1.) Hypoxia
2.) Pain
3.) Infection
4.) Cognitive impairment or disorientation
5.) Malnutrition
