cognitive disorders Flashcards
diff btwn delirium and dementia
see pg 96
causes of delirium
AEIOU TIPS
alcohol/drugs toxicity or withdrawal electrolyte abnormality iatrogenic (see pg 91) oxygen hypoxia (bleeding, central venous, pulmonary) uremia/hepatic encephalopathy trauma infec poisons seizures (postictal), stroke
clinical manifestations of delirium
disorientation: usually to time or place, rarely to person
language disturbances: dysarthria, dysnomia, dysgraphia, aphasia
changes in speech: slow, pressured, rambling, or diorganized
perceptual disturbances: misinterpretations, illusions, or hallucinations
sleep disturbances: sundowning with daytime drowsiness and nighttime insomnia and confusion
disturbed psychomotor behavior: hyperactivity or hypoactivity
emotional disturbances: anxiety, fear, depression, irritability, anger, apathy, euphoria
perseveration
diagnosis of delirium
pg 92
dementia
impairment of memory and other cognitive fxns (lang skills, behavior, personality) w/o alteration in level of consciousness
diagnosis of dementia
pg 93
delusions and hallucinations occur in what percent of demented pts
30
workup for reversible causes of dementia
CBC electrolytes TFTs VDRL/RPR B12 and folate levels brain CT or MRI
what is considered dysfxn on MMSE?
score under 25
AD affects who more: women or men?
women-three times more than men
biology of AD
decrease in Ach due to loss of noradrenergic neurons in basal ceruleus and decreased choline acetyltransferase
motor and sensory symptoms of AD present when
late in the course
cholinesterase inhibitors for AD-list them
for mild to mod dis
tacrine, donepezil, rivastigmine, galantamine
NMDA antagonists for AD-list them
for mod to severe dis
memantine
core feature of lewy body dementia
waxing and waning of cognition
