Confusion and delirium Flashcards

1
Q

modifiable risk factors with dementia?

A

smoking
alcohol
bp
cholestrol

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2
Q

delirium symptoms?

A
abnormal sleep wake cycle 
worse at night 
acute/subacute onset 
altered consciousness 
impaired attention 
disorganised thinking
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3
Q

why are delirium pts high risk?

A

less well medically and socially
future dementia risk is increased
level of care needed is also higher

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4
Q

define delirium?

A

acute onset of confusion and cognitive impairment, usually reversible

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5
Q

Define dementia?

A

chronic progressive, diffuse impairment of cognition

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6
Q

is diffuse impairment following brain insult?

A

hypoxic brain injury

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7
Q

focal impairement due to focal brain lesions?

A

stroke

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8
Q

mild cognitive impairment? (MCI)

A

mild reduction in cognition

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9
Q

three outcomes of MCI?

A

cognitive deteriorates
stable cognition
cognitive improvement

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10
Q

state two impairments for dementia?

A

language, memory, abstract thinking, praxis, visuospatial abilities, personality and social behaviour

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11
Q

state cognitive domains?

A

language, memory, abstract thinking, praxis, visuospatial abilities, personality and social behaviour

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12
Q

receptive dysphasia?

A

speech fluent but non sensical
invented words/jargon
comprehension impaired
wernicke’s area in temp lobe

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13
Q

expressive dysphasia?

A

effortful, non fluent
difficulty finding right words
broca’s area in the pre-frontal cortex

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14
Q

frontal executive function tests?

A

list as many animals as you can in one minute

cognitive estimates

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15
Q

dyspraxia?

A

unable to perform complex motor tasks
difficulty in performing and miming tasks
difficulty copying meaningless gestures
usually left frontal or parietal lobe lesions

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16
Q

visuospatial problems

A

disorientation: poor spatial memory
failure to recognise landmarks
constructional problems: identify two interlocked pentagons

17
Q

personality which lobe and what happens in patients with dementia

A

frontal lobes
disinhibition and impulsive behaviours
apathy
fall in standards of personal hygiene

18
Q

how to diagnose dementia?

A

single focal cognitive defecit is not dementia

long standing, static cognitive impairment do not have dementia

19
Q

cognitive examination?

A

level of alertness
orientation to time place and person
attention and concentration

20
Q

memory types?

A

anterograde: remembering address
retrograde: remembering ww1 dates
patients life story is autobiographical memory

21
Q

visuospatial tests?

A

identify pics
miming and actions
reading and writing

22
Q

cognitive tests?

A

abbreviated mental test : 10qs, quick simple and basic

montreal cognitive assessment: 30 points can be abbreviated into multiple languages

23
Q

why do special tests exist?

A

to differentiate between poor effort and poor ability

24
Q

treatable causes of dementia?

A
B12 deficiency 
hypothyroidism 
syphilis 
subdural haematoma 
normal pressure hydrocephalus 
tumours
HIV
25
Investigating dementia?
thyroid function, b12, folate and copper HIV and syphilis testing CT brain scan csf examination
26
Most common cause of dementia?
alzheimers disease
27
alzheimers disease prevalance?
at 65 years: 1.2 per 1000 affected at 90 years: 53 per 1000 w>m
28
what may help with alzheimers disease?
anti cholinesterase inhibitors
29
what genes are main culprits of alzheimers disease?
Amyloid precursor gene, Apo E and Presenilin
30
what is dementia with lewy bodies?
dementia first then get parkinsons- visual hallucinations atrophy, depigmentation of the substantia nigra lewy bodies deposited in cortical neurons
31
vascular dementia? risk factors?
dementia due to multiple infarcts | risk factors: smoking, hypertension and vascular disease
32
fronto temporal dementia?
``` selective atrophy of the frontal and temporal lobes loss of word knowledge personality change lack of insight emotional and behavioural problems ```
33
rare causes of dementia?
``` HIV/AIDS huntingtons syphilis multiple sclerosis rare types of alzheimers: posterior cortical atrophy ```
34
alcohol effects?
acute toxication: confusion chronic abuse: brain atrophy wernicke korsokoff syndrome: acute brain damage due to thiamine deficiency.