Consultant-Liaison Flashcards

1
Q

Common neurocognitive deficits associated with brain tumors and whst they can be confused with

A

Low energy, fatigue, urge to sleep, loss of interest in daily activities, abulic, lack spontaneity. Can be confused with depression

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2
Q

Most common clinical symptoms at the time of first manifestation of autoimmune encephalitis?

A

Psychotic symptoms

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3
Q

Warning signs of autoimmune encephalitis

A
  • psychotic symptoms
  • subacute onset (rapid progression within 3 months despite psychopharmacotherapy)
  • decreased consciousness level
  • memory deficits/disorientation
  • catatonia
  • speech dysfunction
  • abnormal posture/movement
  • autonomic dysfunction
  • hyponatremia
  • other autoimmune dx
  • epileptic seizures/faciobrachial dystonic seizures
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4
Q

Normal pressure hydrocephalus

A

Wet: urinary incontinence
Wobbly: gait disturbance
Wacky: cognitive impairment

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5
Q

What can steroids cause

A

Euphoria, hypo mania, depression, mood issues, cognition, sleep, delirium, psychosis

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6
Q

What does Yasmin and Beta blocker increase risk of

A

Depression

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7
Q

What can ketamine cause

A

Dissociation associated with confusion, fear or euphoria

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8
Q

What can levodopa cause

A

Depression, psychosis, impulse control disorders

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9
Q

What can levitiracetam cause

A

Behavioural changes like agitation, irritability, depression, anxiety

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10
Q

Cushing’s syndrome assoc with

A

Depression, mania, psychosis

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11
Q

Pheochromocytoma

A

Anxiety

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12
Q

Addison’s disease

A

Depression, psychosis, anxiety, mania

Fatigue, LOW, salt craving, hypotension, hypopigmentation

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13
Q

PCOS

A

Depression, anxiety, OCD, bipolar, schiz

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14
Q

Delirium criteria

A

A. Disturbance in attention and awareness (orientation to environment)
B. It develops over a short period of time (hours to days) and is a change from baseline awareness, tends to fluctuate in severity over a course of a day
C. An additional disturbance in cognition (eg memory, disorientation, language, visuospatial ability, perception
D. disturbances in A&C not better explained by other pre-existing neurocognitive disorder and do not occur in the context of a severely reduced level of arousal like coma
E. there is evidence from history, PE, or lab findings that disturbance is a direct physiological consequence of another medical condition, substance intoxication or withdrawal or exposure to toxins or has multiple etiologies

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15
Q

Risk factors for delirium

A

65 and above, cognitive impairment, hip fracture, severe physical illness, history of depression, use of physical restraints, poly pharmacy, post-op, past episodes of delirium, ICU admission, sleep deprivation, substance withdrawal

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16
Q

Assessment of delirium

A

History and PE: vital signs, alertness level, eyes, urine, mucous membranes, skin
Confusion Assessment Method
RBG, ABG, ECG, urinalysis
FBC, UEC, LFT, TFT, urine drug screen, BAL, therapeutics drug levels
May need CT/MRI, EEG, LP

17
Q

Management of delirium

A

Treat underlying cause
Environment: quiet, low light, orienting strategies, family visiting, constant nurse
Pharmacology
- haloperidol
- benzo only for alcohol/benzo withdrawal
Minimize risks associated with delirium
Ensure regular food, fluid, bowl motions
Encourage mobility, sleep hygiene
Manage pain and avoid bed sores
Educate family