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Medpsych: Test 4 > Delirium and Dementia > Flashcards

Delirium and Dementia Flashcards

1
Q

what is delerium?

A

Acute and Potentially Reversible State of Confusion
Disturbance of Consciousness
Sx will Fluctuate

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2
Q

what is there a high risk of during delirium?

A

suicide

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3
Q

what occurs during Acute Onset/Fluctuating Mental Status?

A

Fluctuating Levels of Consciousness Cognitive Skills, including Memory, Language, and Organization

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4
Q

what drugs can alter delirium?

A

Polypharmacy, EtOH, Anticholinergics, Narcotics, Antipsychotics, Sedatives, Hypnotics, Diuretics, Anti-PD Agents, Antihistamines

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5
Q

what kinds of metabolic dysfx cause delirium?

A

Renal failure, Sodium, Calcium, Fluid Status, BG, Hepatic, Thyroid, Vitamin Deficiencies-B1,B6,B12

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6
Q

how can hypoxia cause delirium?

A

(Heart, Lungs, Anemia) due to lack of 02 to brain

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7
Q

what kinds of anatomic brain disorders cause delirium?

A

Stroke, Trauma, Infection, Tumor, Neuro Pressure Hydrocephalitis, Pain, Stress

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8
Q

how does infection cause delirium?

A

from surgery causing pneumonia, UTI, Respiratory, Cellulitis, AIDS, Encephalitis, Meningitis

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9
Q

what is hyperactive delirium?

A

Agitated, Disoriented, Delusional, Hallucinations

May be Confused with Schizophrenia, Agitated dementia, or Psychosis

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10
Q

what is hypoactive delirium?

A

Subdued, Quietly Confused, disoriented, and Apathetic

may Go Unrecognized or Be Confused With Depression or dementia

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11
Q

what is mixed delirium?

A

Fluctuations Between Hyper and Hypo Active subtypes

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12
Q

what are sxs of delirium?

A 
INATTENTION
DISORGANIZED THINKING
ALTERED LEVEL OF CONSCIOUSNESS
DISORIENTATION 
MEMORY IMPAIRMENT 
PERCEPTUAL DISTURBANCES
MOTOR DISTURBANCES
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13
Q

what is dementia?

A

Development of multiple cognitive deficits that include memory impairment and one cognitive disturbance: aphasia, apraxia, agnosia, or Executive dysFx

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14
Q

what % of people over 80 have dementia?

A

50%

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15
Q

what type of dementia is most prevalent?

A

alzheimers

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16
Q

what are the risk factors of dementia?

A 
Age, Age, Age
Gender- woman
Level of education
1st degree relative
head injury
17
Q

what does a higher education level affect?

A

Protective factor of signs + symptoms of dementia but not disease

18
Q

what are the cognitive deficits of cortical dementia?

A

Memory and language difficulties (Aphasia) most pronounced symptoms.
Info processing deficits

19
Q

what are the repercussions of cortical vs subcortical dementia?

A

subcortical Memory loss & language difficulties not present or less severe than cortical

20
Q

what are the cognitive deficits of subcortical dementia?

A

Changes in personality and attention span

21
Q

what is the criteria for alzheimers dementia?

A
  1. Memory Impairment
  2. Other Cognitive Impairment
  3. Gradual Onset And Decline
22
Q

what is alzheimers dementia?

A

Severe amnesia

Deficits in language, EF, attention, Visuospatial and constructional abilities

23
Q

how do you tx alzheimers?

A

aricept: ACHesterase inhibitor so that ACH stays in synapse longer

24
Q

what exam is used to test alzheimers dementia?

A

MMSE = mini mental status exam

shows decline beginning 8 years before diagnosis

25
Q

what occurs during early stage alzheimers?

A 
2-3 years
Begins with forgetfulness
Progresses to disorientation and confusion
Personality changes
Symptoms of depression/manic b
26
Q

what occurs during middle stage alzheimers?

A 
2-10 years 
assistance with ADLs
Unable to remember names
Loss of short-term recall
anxious, agitated, delusional, obsessive behavior
physically or verbally aggressive
Poor hygiene
Disturbed sleep
Inability to carry conversation
use sentence fragments
Posture altered
Disoriented to time and place
ask questions repeatedly
27
Q

what occurs during late stage alzheimers?

A 
8-12 years
Loss of verbal articulation
Loss of ambulation
Bowel and bladder incontinence
Extended sleep patterns
Unresponsive to most stimuli
28
Q

what is the criteria for Vascular Dementia?

A
  1. Memory Impairment
  2. Other Cognitive Disturbances
  3. short onset
29
Q

what causes Vascular Dementia?

A

One or more strokes

30
Q

what is the clinical manifestation of vascular dementia?

A

Sudden appearance of Sx

More apraxia, falls, and rapid shuffling steps than in AD

31
Q

who is vascular dementia more likely to happen to?

A

More likely in men

32
Q

what are the 1st sxs of Frontotemporal Dementia aka Pick’s Disease?

A

emotional changes, disinhibition, deterioration in social skills

33
Q

what are later sxs of Frontotemporal Dementia aka Pick’s Disease?

A

become extrovert or withdrawn, rude, impatient, aggressive and make inappropriate remarks in public. Increase in sexual behavior, hyperorality

hallmark feature: Disinhibition & Apathy

34
Q

what is Dementia with Lewy Bodies often misdiagnosed as?

A

AD, Delirium, PD

b/c it Has tremors

35
Q

what are the sxs of Dementia with Lewy Bodies?

A 
Repeated falls
Syncope
Transient (brief) LOC
Delusions
Hallucinations*
Rapid Eye Movement (REM) sleep disorder
Hand Tremors*
Cognitive decline*
36
Q

when does Transient Global Amnesia occur?

A

after a physical or emotional stressful event

37
Q

what occurs during Transient Global Amnesia?

A

Sudden onset of memory loss, verified by a witness
Retention of personal identity despite memory loss
Normal cognition
no more than 24 hours
Gradual return of memory

38
Q

what are risk factors of Transient Global Amnesia?

A

Age (56-75 y/o) & Migraines

Medpsych: Test 4 (8 decks)

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