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Neurology (inpt) > Delirium > Flashcards

Delirium Flashcards

1
Q

delirium

A

characterized by alteration of consciousness, waxing and waning of sx, psychomotor retardation or agitation, decreased attention span

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2
Q

what meds can you recommend?

A

lorazepam or halo

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3
Q

causes of Delerium

A

MOVE STUPID

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4
Q

MOVE

A

Metabolic-hepatic encephalopahty, thiamine deficiency, hypoglycemia

Oxygen- hypoxia, hypercapnea

V-vascular, MI

Endocrine, electrolytes- hypoN, hyperCa, fluid imbalance, thyroid issues

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5
Q

STUPID

A

Sz

Trauma, tumor, temp

Uremia-acute renal failure, dehydration

Pyschogenic

Infection/intoxication-UTI, PNA, meningitis, sepsis, EToH, benzos, CO, barbiturates

Drugs/degenration

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6
Q

S/X

A

hallucinations, delusions, agitation, persecutory thoughts are common

  • anxiety, paranoia, or combativeness
  • sx worse at night “sundowning”
  • decreased attention span, decreased short term memory, reversed sleep-wake cycles
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7
Q

Work up

A

everything

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8
Q

rx of delirium

A

underlying cause

normalize fluids/electrolyes, appropriate sensory environment

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9
Q

what meds do you want to avoid in tx of delirium?

A

Benzos!!! can make sx worse for pts

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10
Q

Dementia

A

progressive impairment of intellectual functioning w/ compromise in a least 2 of the following spheres of mental activity: language, memory, visuospatial skills, emotional behaviour, personality, cognition

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11
Q

what are some types of dementia?

A

alzheimer, vascular, can have dementia from PD, Huntingtons, frontotemporal dementia, HIV, creutzfeldt-jakob, toxins, depression, hydrocephalus

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12
Q

Alzheimer RF

A

old age, Fmhx, lower education level, female

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13
Q

what chromosomes are associated w. alzheimer

A

1, 14, 19, 21

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14
Q

what is the pathology of alzheimer

A

intracellular neurofibrillary tangles and extracellular neuritic plaque

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15
Q

sx of alzheimer

A

progressive memory loss (anterograde amnesia is first sign), disorientation, language difficulties, inablitly to perform complex motor activities, inattention, visual misperception, poor problem-solving abilities, inappropriate social behavior, hallucinations

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16
Q

acalculia

A

inability to perform math

17
Q

tx for alzheimer

A

low doses to tx insomina, agitation depression

18
Q

memantine?

A

NMDA receptor antagoinst that is thought o regulate gluatmate, and has been apporved for use in severe AD

19
Q

Vitamin E and selegiline?

A

antioxidants- may slow cognitive deline

20
Q

what can help improve memory fxn?

A

tacrine, donepezil, galantamine, rivastigmine

acetylcholinesterase inhibitors

21
Q

vasular dementia

A

” multiinfarct dementia” includes lacunar and mult cortical infarctions

22
Q

vascular dementia associations?

A

HTN, M,

23
Q

VD sx

A

forgetfulness in the absence of depression and inattentiveness

-stepwise fashing and related to the area of the CNS affected

24
Q

cortical VD

A

speech difficulty, trouble performing routine tasks, sensory interpration difficulty, confusion, amnesia, executive dysfxn

25
Q

subcortical sx VD

A

gait problems, urinary difficulties, motor deficites, personality changes

–

26
Q

other features of VD

A

social behaviors may be well maintained, **mental status

27
Q

progression of VD

A

loss of computational ability, problems w/ word finding and concentration, ADL, ultimatley complete disoreitnation and social w/drawal

28
Q

tx of VD

A

control HTN, metabolic dz

29
Q

frontotemporal dementai

etiology

A

Pick dz, amyotrophic lateral sclerosis

30
Q

frontal lob sx

A

behavioral (euphoria, apathy, disinhibtion) and compulsive dx

31
Q

what are other fx of FLD

A

primitive reflexes

32
Q

work up of FLD

A

MRI-may show frontal and/or anterior temoral lobe atrophy

PET- hypometabolis

33
Q

Pseudodementia

A

pts w. psychiatric illness who appear demented

-MDD

34
Q

PDementaia CF

A

pts typically complain of memory problems, but attention span and concentration appear intact while appearing upset or distressed

**in true dementia, pts will often give wrong answers, have poor attention and concentration, and appear indifferent or unconcerned

Neurology (inpt) (10 decks)

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