Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Specialites Summary > Confusion > Flashcards

Confusion Flashcards

1
Q

The 6 neurocognitive domains

A 
Complex attention 
Perceptual motor function 
Language function 
Executive function 
Learning / memory 
Social cognition
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Complex attention is made up of…

A

Sustained attention
Divide attention
Selective attention
Processing speed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Perceptual motor function is made up of….

A

Visual perception
Visuo-constructional reasoning
Perceptual motor coordination

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Language function is made up of…..

A 
Object naming
Word finding
Fluency 
Grammar and syntax 
Receptive language
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Executive function is made up of….

A 
Planning
Decision making
Working memory
Responding to feedback 
inhibition 
flexibility
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Learning / memory is made up of….

A 
Free recall
cued recall 
recognition memory 
semantic and autobiolographal long term memory 
Implicit learning
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Social cognition is made up of…..

A

Recognition of emotions
Theory of mind
Insight

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Diagnosing cause of cognitive impairment - things to find out

A 
Onset
- when 
- how rapid
Course
- fluctuating
- progressive decline
Associated features
- other illness
- functional loss e.g. reduced mobility, reduced self care, new incontinence
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Subtypes of delirium

A

Hyperactive
Hypoactive
Mixed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Presentation of delirium

A 
Disturbed consciousness 
(hypoactive, hyperactive, mixed) 
Change in cognition 
- memory / perceptual / language / illusions / hallucinations 
Acute onset and fluctuant 
Disturbance of sleep wake cycle
Disturbed psychomotor behaviour 
Emotional disturbance
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Precipitants of delirium

A 
Infection (not always UTI)
Dehydration 
Biochemical disturbance 
Pain 
drugs 
constipation/urinary retention 
hypoxia 
alcohol / drug withdrawal 
sleep disturbance 
brain injury (stroke, tumour, bleed etc) 
Changes in environment 
Sometimes no idea and multiple triggers
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the most common complication of hospitalisation?

A

Delirium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Who is delirium common in?

A

50% post surgery
20-30% of all inpatients
up to 85% last weeks of life

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Diagnosis of delirium

A 
Alterness 
AMT4
- age 
- DOB 
- place
- current year 
Attention 
Acute change of fluctuating course
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What score of 4AT score indicates possible delirium?

A

4 or above

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What does a score of 1-3 on the 4AT indicate?

A

Possible cognitive impairment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Treatment of delirium

A 
Treat cause
- TIME bundle 
Pharmacological measures
- stop bad drugs (anticholinergics, sedatives)
- drug treatment usually not necessary 
- danger to themselves / cannot be settled = quetiapine orally 
Re-orientate and reassure patients (use family / carers)
Encourage mobility and self care
Correction of sensory impairment 
Normalise sleep wake cycle 
ensure continuity of care 
- avoid frequent ward or room transfers 
Avoid urinary catheterisation/venflons
18
Q

What is dementia?

A

Acquired decline in memory and other cognitive functions in an alert person sufficiently severe to cause functional impairment and present for more than 6 months

19
Q

Types of dementia

A 
Alzheimer's
Vascular 
Mixed Alzheimer's / vascular 
Dementia with Lewy bodes 
'Reversible' causes
20
Q

Features of Alzheimer’s

A

Slow insidious onset
loss of recent memory first
progressive functional decline

21
Q

Risk factors for Alzheimer’s

A

AGE
vascular risk factors
genetics

22
Q

What is lost first in Alzheimer’s?

A

Recent memory

23
Q

Features of Vascular dementia

A

Classically step wise deterioration
executive dysfunction may predominate rather than memory impairment
often associated with gait problems

24
Q

Risk factors for vascular dementia

A

Vascular RFs

  • T2DM
  • AD
  • IHD
  • PVD
25
Q

Features of dementia with Lewy bodies

A

May have parkinsonism
Often very fluctuant
Hallucinations common
falls common

26
Q

Features of fronto-temporal dementia

A

Onset often earlier age
Early symptoms different from other types of dementia
- behavioural change
- language difficulties
- memory early on not so affected
Usually lack of insight into difficulties

27
Q

What is key in the diagnosis of Dementia

A

history

28
Q

Treatment of dementia

A 
Non-pharmacological 
- support for family / carers
- cognitive stimulation 
- exercise
- avoiding changes in environment / social support etc 
- advanced care planning
- environmental design 
Pharmacological 
- cholinesterase inhibitors 
- anti-psychotics (avoid if possible)
29
Q

Reversible causes of dementia

A 
Hypothyroidism 
Intracerebral bleeds/tumours
B12 deficiency 
Hypercalcaemia 
Normal pressure hydrocephalus 
Depression
30
Q

What is always something to remember in the possible reversible causes of dementia?

A

Depression

31
Q

What is delirium also known as?

A

Acute confusional state

Acute organic brain syndrome

32
Q

What % of elderly are affected of acute confusional state in hospital?

A

30%

33
Q

Predisposing factors to acute confusional state

A 
> 65 y/o
Background of dementia 
Significant injury e.g. hip fracture 
Frailty or multimorbidity 
Polypharmacy
34
Q

Precipitating evens for acute confusional state

A

Infection
Metabolic (hypercalcaemia, hypoglycaemia, hyperglycaemia, dehydration)
Change of environment
Any significant CVS, resp, neurological or endocrine condition
Severe pain
Alcohol withdrawal
Constipation

35
Q

What infection in particular particularly causes acute confusional state?

A

UTI

36
Q

Presentation of acute confusional state (variety of presentations)

A 
Memory disturbances (loss of short > long term)
Very agitated or withdrawn 
Disorientation 
Mood change
Visual hallucinations
Disturbed sleep cycle
Poor attention
37
Q

Management of acute confusional state

A

Treat underlying cause
Modification of environment
Haloperidol 0.5mg first line sedative

38
Q

What does the 4AT look at?

A
  1. Alertness
  2. AMT 4
  3. Attention
  4. Acute change or fluctuating course
39
Q

What is looked at in the alertness section of the 4AT?

A

Normal (fully alert, non agitated, throughout assessment)
Mild sleepiness for < 10 seconds after waking, then normal
Clearly abnormal

40
Q

What is looked at in the AMT 4 section of the 4AT?

A

Age
DOB
Where they are
Current year

41
Q

What is looked at in the attention section of the 4AT?

A

Patient is asked to tell the months of the year in backwards order, starting in December.
Achieves 7 months or more correctly
Starts but scores < 7 months / refuses to start
Untestable (cannot start cause unwell / drowsy / inattentive)

42
Q

What is looked at in the acute change or fluctuating course section of the 4AT?

A

Evidence of significant change or fluctuation in alertness, cognition, other mental function (e.g. paranoia, hallucinations) over the last 2 weeks and still evident in the last 24 hours

Specialites Summary (15 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions