Confusion and delirium

Question 1

modifiable risk factors with dementia?

Answer 1

smoking
alcohol
bp
cholestrol

Question 2

delirium symptoms?

Answer 2

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

Question 3

why are delirium pts high risk?

Answer 3

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

Question 4

define delirium?

Answer 4

acute onset of confusion and cognitive impairment, usually reversible

Question 5

Define dementia?

Answer 5

chronic progressive, diffuse impairment of cognition

Question 6

is diffuse impairment following brain insult?

Answer 6

hypoxic brain injury

Question 7

focal impairement due to focal brain lesions?

Answer 7

stroke

Question 8

mild cognitive impairment? (MCI)

Answer 8

mild reduction in cognition

Question 9

three outcomes of MCI?

Answer 9

cognitive deteriorates
stable cognition
cognitive improvement

Question 10

state two impairments for dementia?

Answer 10

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

Question 11

state cognitive domains?

Answer 11

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

Question 12

receptive dysphasia?

Answer 12

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

Question 13

expressive dysphasia?

Answer 13

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

Question 14

frontal executive function tests?

Answer 14

list as many animals as you can in one minute

cognitive estimates

Question 15

dyspraxia?

Answer 15

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

Question 16

visuospatial problems

Answer 16

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

Question 17

personality which lobe and what happens in patients with dementia

Answer 17

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

Question 18

how to diagnose dementia?

Answer 18

single focal cognitive defecit is not dementia

long standing, static cognitive impairment do not have dementia

Question 19

cognitive examination?

Answer 19

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

Question 20

memory types?

Answer 20

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

Question 21

visuospatial tests?

Answer 21

identify pics
miming and actions
reading and writing

Question 22

cognitive tests?

Answer 22

abbreviated mental test : 10qs, quick simple and basic

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

Question 23

why do special tests exist?

Answer 23

to differentiate between poor effort and poor ability

Question 24

treatable causes of dementia?

Answer 24

B12 deficiency 
hypothyroidism 
syphilis 
subdural haematoma 
normal pressure hydrocephalus 
tumours
HIV

Question 25

Investigating dementia?

Answer 25

thyroid function, b12, folate and copper
HIV and syphilis testing
CT brain scan
csf examination

Question 26

Most common cause of dementia?

Answer 26

alzheimers disease

Question 27

alzheimers disease prevalance?

Answer 27

at 65 years: 1.2 per 1000 affected
at 90 years: 53 per 1000
w>m

Question 28

what may help with alzheimers disease?

Answer 28

anti cholinesterase inhibitors

Question 29

what genes are main culprits of alzheimers disease?

Answer 29

Amyloid precursor gene, Apo E and Presenilin

Question 30

what is dementia with lewy bodies?

Answer 30

dementia first then get parkinsons- visual hallucinations

atrophy, depigmentation of the substantia nigra
lewy bodies deposited in cortical neurons

Question 31

vascular dementia? risk factors?

Answer 31

dementia due to multiple infarcts

risk factors: smoking, hypertension and vascular disease

Question 32

fronto temporal dementia?

Answer 32

selective atrophy of the frontal and temporal lobes 
loss of word knowledge 
personality change 
lack of insight 
emotional and behavioural problems

Question 33

rare causes of dementia?

Answer 33

HIV/AIDS 
huntingtons 
syphilis
multiple sclerosis
rare types of alzheimers: posterior cortical atrophy

Question 34

alcohol effects?

Answer 34

acute toxication: confusion
chronic abuse: brain atrophy
wernicke korsokoff syndrome: acute brain damage due to thiamine deficiency.