Delirium and Dementia

Question 1

what is delerium?

Answer 1

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

Question 2

what is there a high risk of during delirium?

Answer 2

suicide

Question 3

what occurs during Acute Onset/Fluctuating Mental Status?

Answer 3

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

Question 4

what drugs can alter delirium?

Answer 4

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

Question 5

what kinds of metabolic dysfx cause delirium?

Answer 5

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

Question 6

how can hypoxia cause delirium?

Answer 6

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

Question 7

what kinds of anatomic brain disorders cause delirium?

Answer 7

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

Question 8

how does infection cause delirium?

Answer 8

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

Question 9

what is hyperactive delirium?

Answer 9

Agitated, Disoriented, Delusional, Hallucinations

May be Confused with Schizophrenia, Agitated dementia, or Psychosis

Question 10

what is hypoactive delirium?

Answer 10

Subdued, Quietly Confused, disoriented, and Apathetic

may Go Unrecognized or Be Confused With Depression or dementia

Question 11

what is mixed delirium?

Answer 11

Fluctuations Between Hyper and Hypo Active subtypes

Question 12

what are sxs of delirium?

Answer 12

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

Question 13

what is dementia?

Answer 13

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

Question 14

what % of people over 80 have dementia?

Answer 14

50%

Question 15

what type of dementia is most prevalent?

Answer 15

alzheimers

Question 16

what are the risk factors of dementia?

Answer 16

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

Question 17

what does a higher education level affect?

Answer 17

Protective factor of signs + symptoms of dementia but not disease

Question 18

what are the cognitive deficits of cortical dementia?

Answer 18

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

Question 19

what are the repercussions of cortical vs subcortical dementia?

Answer 19

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

Question 20

what are the cognitive deficits of subcortical dementia?

Answer 20

Changes in personality and attention span

Question 21

what is the criteria for alzheimers dementia?

Answer 21

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

Question 22

what is alzheimers dementia?

Answer 22

Severe amnesia

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

Question 23

how do you tx alzheimers?

Answer 23

aricept: ACHesterase inhibitor so that ACH stays in synapse longer

Question 24

what exam is used to test alzheimers dementia?

Answer 24

MMSE = mini mental status exam

shows decline beginning 8 years before diagnosis

Question 25

what occurs during early stage alzheimers?

Answer 25

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

Question 26

what occurs during middle stage alzheimers?

Answer 26

``` 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 ```

Question 27

what occurs during late stage alzheimers?

Answer 27

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

Question 28

what is the criteria for Vascular Dementia?

Answer 28

1. Memory Impairment 2. Other Cognitive Disturbances 3. short onset

Question 29

what causes Vascular Dementia?

Answer 29

One or more strokes

Question 30

what is the clinical manifestation of vascular dementia?

Answer 30

Sudden appearance of Sx | More apraxia, falls, and rapid shuffling steps than in AD

Question 31

who is vascular dementia more likely to happen to?

Answer 31

More likely in men

Question 32

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

Answer 32

emotional changes, disinhibition, deterioration in social skills

Question 33

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

Answer 33

become extrovert or withdrawn, rude, impatient, aggressive and make inappropriate remarks in public. Increase in sexual behavior, hyperorality hallmark feature: Disinhibition & Apathy

Question 34

what is Dementia with Lewy Bodies often misdiagnosed as?

Answer 34

AD, Delirium, PD | b/c it Has tremors

Question 35

what are the sxs of Dementia with Lewy Bodies?

Answer 35

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

Question 36

when does Transient Global Amnesia occur?

Answer 36

after a physical or emotional stressful event

Question 37

what occurs during Transient Global Amnesia?

Answer 37

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

Question 38

what are risk factors of Transient Global Amnesia?

Answer 38

Age (56-75 y/o) & Migraines