504-505 Cognitive d/o, delirium, dementia, psychosis, schizo, delusional

Question 1

What are the components of cognition?

Answer 1

memory, attention, language, and judgment

Question 2

What are the effects of delirium on:

1. consciousness
2. attention span
3. level of arousal
4. thinking
5. sleep
6. cognition

Answer 2

1. “waxing and wanning” level of consciousness with acute onset
2. rapid ↓ in attention span
3. rapid ↓ in level of arousal
4. disorganized thoughts, hallucinations, illusions, misperceptions
5. disturbance in sleep-wake cycle
6. cognitive dysfunction

Question 3

What are the causes of delirium?

Answer 3

Usually secondary to other illness:
- CNS diseases, infection, trauma, substance abuse/withdrawal, metabolic/electrolyte disturbances, hemorrhage, urinary/fecal retention

Question 4

What is dementia?

Answer 4

Gradual ↓ in intellectual ability or “cognition” w/out affecting level of consciousness

Question 5

What are the symptoms of dementia?

Answer 5

memory deficits, aphasia, agnosia, loss of abstract thought, behavioral/personality changes, impaired judgement

Question 6

What are irreversible causes of dementia?

Answer 6

Alzheimer disease, Lewy body dementia, Huntington disease, Pick disease, cerebral infarcts, CJD, chronic substance abuse (→ neurotoxicity)

Question 7

Reversible causes of dementia:

Answer 7

NPH, vitamin B12 deficiency, hypothyroidism, neurosyphilis, HIV (partially)

Question 8

dementia epidemiology:

Answer 8

incidence ↑ w/ age

Question 9

EEG findings in dementia:

Answer 9

abnormal

Question 10

In elderly patients, what can mimic dementia? What is this called?

Answer 10

depression; psuedodementia

Question 11

What is psychosis?

Answer 11

a distorted perception of reality characterized by delusions, hallucinations, and/or disorganized thinking

Question 12

What kinds of patients are affected by psychosis?

Answer 12

patients with medical illness, psychiatric illness, or both

Question 13

Hallucinations are:

Answer 13

perceptions in the absence of external stimuli (e.g. seeing a light that is not actually present)

Question 14

Delusions are:

Answer 14

unique, false beliefs about oneself or others that persist despite the facts (e.g. thinking aliens are communicating with you)

Question 15

What is disorganized speech?

Answer 15

Words and ideas ares strung together based on sounds, puns, or “loose associations”

Question 16

What are the types of hallucination?

Answer 16

Visual, auditory, olfactory, gustatory, tactile, hypnagogic, and hypnopompic

Question 17

What type of hallucination is more commonly associated with medical illness than psychiatric illness?

Answer 17

Visual hallucinations

Question 18

What type of hallucination is more commonly associated with psychiatric illness than medical illness?

Answer 18

Auditory hallucinations

Question 19

When do olfactory hallucinations usually occur?

Answer 19

as an aura of psychomotor epilepsy and in brain tumors

Question 20

When do tactile hallucinations commonly present?

Answer 20

alcohol withdrawal (e.g. formication - sense of bugs crawling on one’s skin) and cocaine abusers (“cocaine crawlies”)

Question 21

When do you see hypnagogic hallucinations?

Answer 21

When you GO to sleep

Question 22

When do you see hypnapompic hallucinations?

Answer 22

When you wake up

Question 23

What is schizophrenia?

Answer 23

A chronic mental disorder with periods of psychosis, disturbed behavior and thought, and decline in functioning that lasts > 6 months.

Question 24

What abnormal level of what neurotransmitter activity is found in schizophrenia?

Answer 24

↑ dopaminergic activity

Question 25

What is the effect of schizophrenia on neurons?

Answer 25

↓ dendritic branching

Question 26

What are the positive symptoms of schizophrenia?

Answer 26

1. Delusions
2. Hallucinations - often auditory
3. Disorganized speech (loose associations)
4. Disorganized or catatonic behavior

Question 27

What are the negative symptoms of schizophrenia?

Answer 27

1. flat affect
2. social withdrawal
3. lack of motivation
4. lack of speech or thought

Question 28

What is the etiology of schizophrenia

Answer 28

genetics and environment contribute

Question 29

Lifetime prevalence and groups affected by schizophrenia:

Answer 29

1.5% (♂ = ♀ ; black = white)

Question 30

When does schizophrenia present in males?

Answer 30

late teens - early 20s

Question 31

When does schizophrenia present in females?

Answer 31

late 20s to early 30s

Question 32

What is a complication of schizophrenia?

Answer 32

↑ risk for suicide

Question 33

How many positive and negative symptoms must be present for a diagnosis of schizophrenia? For how long?

Answer 33

2 or more symptoms, positive or negative; for > 6 months

Question 34

What is an environmental association with the onset of schizophrenia in teenagers?

Answer 34

frequent cannabis use

Question 35

What is the disorder called when schizophrenia symptoms are present for < 1 month?

Answer 35

brief psychotic disorder

Question 36

What is the diagnosis for schizophrenia symptoms lasting for 1-6 months?

Answer 36

schizophreniform disorder

Question 37

What is schizoaffective disorder?

Answer 37

at least 2 weeks of stable mood with psychotic symptoms + a major depressive, manic, or mixed episode

Question 38

What are the subtypes of schizoaffective disorder?

Answer 38

bipolar and depressive

Question 39

What is delusional disorder?

Answer 39

Fixed, persistent, untrue belief system lasting > 1 month. Functioning otherwise not impaired.