Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Year 3 - Mental Health > Demetia and Delirium > Flashcards

Demetia and Delirium Flashcards

1
Q

Define cognitive impairment

A

A disturbance of higher cortical functions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is meant by higher cortical functions?

A

Memory

Thinking

Judgement

Language

Perception

Awareness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

How is cognitive impairment variable?

A

It can affect a single or multiple higher cortical functions.

It can be static or progressive.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Is cognitive impairment a specific illness?

A

No

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

If cognitive impairment is not a specific illness, what is it?

A

A description of someone’s condition

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Define dementia

A

A persistent and disabling cognitive impairment with a decline in memory and thinking sufficient to impair personal ADL’s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What does ADL stand for?

A

Activities of daily living

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What do patients with dementia have problem with?

A

Processing incoming information

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What do patients with dementia have problem with as a result of not being able to process incoming information?

A

Maintaining and directing attention

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What level of consciousness do people with dementia display?

A

Clear consciousness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How long must a person have these symptoms before being diagnosed with dementia?

A

6 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What can often happen despite the commonness of dementia?

A

Missed diagnosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Is dementia static or progressive?

A

Nearly always progressive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is meant by ‘the inverse care law applies to dementia’?

A

Those who are most dependent and vulnerable often have the least awareness of their disability

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What diseases can cause dementia?

A

Alzheimer’s disease

Vascular dementia

Frontotemporal dementia

Dementia with Lewy bodies

Huntington’s disease

Other causes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Describe the features of early stage dementia

A

Forgetfulness and other memory symptoms

Subtle changes in mood and behaviour, e.g. loss of motivation

Usually little intrusion into day to day activities if they are not too demanding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Describe the features if mid-stage dementia

A

More prominent memory problems

Difficulty with language and executive function may emerge

Marked changes in behaviour

More obvious disability

Complex events may be difficult to deal with e.g. managing finances

Usually require frequent support

Awareness of disability may start to diverge from reality

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Describe the features of late stage dementia

A

Severe and pervasive memory problems

Severe disorientation and failure to recognise familiar people

Marked behavioural changes e.g. restlessness, disinhibition, severe apathy

Basic aspects of personal function begin to fail and generally require more or less continuous supervision

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Describe the course and onset of Alzheimer’s

A

Gradual, insidious onset with slow progression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Describe the early symptoms of Alzheimer’s

A

Usually memory impairment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What neurological symptoms are associated with Alzheimer’s?

A

None

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Describe the mood and behavioural changes that can accompany Alzheimer’s

A

May be minimal initially, but pre-existing anxiety may worsen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Describe the structural brain imaging seen in Alzheimer’s

A

Volume loss in the medial temporal lobe, posterior cingulate and precuneus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Describe the course and onset of vascular dementia

A

May be gradual or more abrupt onset

Erratic course

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Describe the early symptoms seen in vascular dementia
Variable, but may be prominent dysexecutive features
26
What neurological features accompany vascular dementia?
Highly variable
27
What mood and behavioural changes may accompany vascular dementia?
Depression is common after a stroke Emotional lability
28
What structural brain imaging changes are seen with vascular dementia?
May be evidence of infarcts, bleeds and white matter ischaemia
29
Describe the course and onset of frontotemporal dementia
Gradual onset but may progress quickly especially in younger patients
30
Describe the early symptoms seen in frontotemporal dementia
Loss of executive function and impaired social behaviours
31
What neurological features are seen with frontotemporal dementia?
Frontal release signs
32
What mood and behavioural changes may be seen in frontotemporal dementia?
Apathy Loss of volition Disinhibition
33
What changes in structural brain imaging can be seen with frontotemporal dementia?
Frontotemporal atrophy
34
Describe the course and onset of Lewy body dementia
Fluctuating episodic course | May initially look like delirium
35
What early symptoms may present in Lewy body dementia?
Perceptual disturbance (hallucinosis) and Parkinsonism
36
What neurological features can accompany Lewy body dementia?
Lots! Mainly Parkinsonism
37
What mood and behavioural changes can accompany Lewy body dementia?
May be paranoia and suspicion arising from psychotic symptoms
38
What changes appear on structural brain imaging in Lewy body dementia?
No specific abnormalities
39
Describe the course and onset of alcoholic dementia
May be a gradual onset but cognitive status fluctuates with drinking and withdrawal episodes
40
What early symptoms present in alcoholic dementia?
Memory problems and dysexecutive features
41
What neurological features accompany alcoholic dementia?
None
42
Describe the mood and behavioural changes that may accompany alcoholic dementia
Depression commonly associated with alcohol misuse problems
43
What structural brain imaging changes can occur?
Age-disproportionate cortical and white matter atrophy
44
How many stages are there in the process of assessing dementia?
2
45
What do the two stages of assessing dementia look at?
The syndrome of dementia and then the disease that causes it
46
What questions are important to ask as part of taking a history of dementia?
What is the course of symptoms over time? Is there evidence of disability or impact on day to day life? Why have they presented now? Has anything happened/changed recently? Have there been any changes in general health?
47
What aspects should make up an examination of a patient with dementia?
Cognitive screening assessment Check for new physical findings if prompted by the history
48
What investigations should be conducted when assessing a patient with dementia?
‘Dementia screen’ of blood - doesn’t screen for dementia itself but screens for other active problems which may be contributing Structural brain imaging (CT or MRI) Functional brain imaging Specialised tests in special situations
49
What specialised tests may be used to assess dementia?
EEG Lumbar puncture
50
What does management of dementia consist of?
Information and explanation Psychological support Practical advice Carer support
51
What do some (but not all) types of dementia need as part of management?
Drug treatments
52
What types of drugs are indicated for Alzheimer’s disease?
Cholinesterase inhibitors NMDA receptor antagonists
53
What cholinesterase inhibitors are used to treat Alzheimer’s disease?
Donzepil Rivastigmine Galantamine
54
What NMDA receptor antagonist is used to treat Alzheimer’s disease?
Memantine
55
When should cholinesterase inhibitors be used in Alzheimer’s?
For mild to moderate disease
56
When should NMDA receptors antagonists be used in Alzheimer’s?
In moderate to severe disease?
57
What drugs should be avoided in patients with Alzheimer’s?
Anticholinergic drugs Benzodiazepines Antipsychotic tranquillisers
58
What drugs should be used to treat patients with Lewy body dementia?
Rivastigmine
59
Define delirium
Acute onset of cognitive deterioration
60
What are the symptoms of delirium
Impairment of cognition (typically fluctuating) Disturbances of attention and conscious level Abnormal psychomotor behaviour and affect Disturbed sleep-wake cycle
61
Over what time period does onset?
Acute - usually within hours or days
62
When are symptoms of delirium at their worst?
Fluctuate throughout the day and worst at night
63
What is the earliest stage of delirium?
Clouding of consciousness characterised by additional deficits
64
What additional deficits can characterise early delirium?
Vague rambling conversation Drifting off the point Undue distractibility
65
In what modality does perceptual disturbance usually occur in delirium?
Visual
66
How does visual perceptual disturbance present in delirium?
Usually fluctuating on a continuum from normal through various stages of perceptual distortion to hallucination.
67
What are the 2 behavioural sub-types of delirium?
Hyperactive Hypoactive
68
What characteristics occur in a patient in a hyperactive delirious state?
Heightened arousal Restlessness Irritability Wandering Carphologia
69
What characteristics occur in a patient in a hypoactive delirious state?
Quiet Sleepy Inactive Unmotivated
70
Which type of delirium is most commonly over looked?
Hypoactive delirium
71
What classes of drugs can cause delirium?
Psychotropic drugs Antiparkinsonian drugs Anticholinergic drugs Opiates Diuretics Recreational drug use and withdrawal
72
What psychotropic drugs can cause delirium?
Anti-depressants Anti-psychotics Benzodiazepines
73
What is used to assess delirium?
Confusion Assessment Method (CAM)
74
What 4 features suggest delirium using the CAM?
1. Acute onset and fluctuating course 2. Inattention 3. Disorganised thinking 4. Altered level of consciousness
75
How is the onset and course of delirium assessed?
Usually obtained from family member/nurse Shown by positive responses to questions e.g. any change in mental status? Did this behaviour fluctuate?
76
How is inattention assessed in delirium?
Did the patient have difficulty focusing attention e.g. easily distracted or difficulty following what was said?
77
How is disorganised thinking assessed in delirium?
Was the patient’s thinking incoherent, e.g. rambling, unclear flow of ideas.
78
Once a patient presents with delirium what immediate actions must be taken?
Collateral history Identify and treat underlying causes Check if patient fits the SIRS Cognitive assessment with AMT 10/MMSE Complete ‘know me better’ profile with carers Heighten level of supervision
79
What can cause delirium?
Trauma Hypoxia Increasing age or fragility NoF# Alcohol withdrawal Drugs Environment changes Lack of sleep I’m a balanced electrolytes Urinary retention/constipation Infection/sepsis Uncontrolled pain
80
What kind of trauma can cause delirium?
Head injury Intracranial event
81
How can hypoxia causing delirium occur?
PE CCF MI COPD Pneumonia
82
What is management of delirium related to?
The underlying cause
83
How is delirium treated if it is caused by hypoxia/electrolytes?
Treat hypoxia/electrolyte imbalance Follow sepsis guidelines
84
How is delirium treated if it is caused by constipation?
PR to exclude impaction Ensure good hydration Laxatives and enemas if required Encourage to sit out on toilet if appropriate
85
How is delirium treated if it is caused by urinary retention?
Treat underlying cause Only catheterise if necessary
86
How is delirium treated if it is caused by pain?
Utilise other routes of analgesia administration Use non-verbal pain scores
87
How does delirium affect the prognosis of acutely ill patients?
Worsens it
88
How does delirium worsen an acutely ill patient’s prognosis?
Lead to increased length of stay Increased complications e.g. falls/infection
89
How does delirium have a relationship with more persistent cognitive impairment?
Pre-existing cognitive impairment is a risk factor for delirium Delirium can take > 3 months to resolve in some cases leading to incorrect diagnosis of dementia Some evidence that some types of delirium can precipitate dementia

Year 3 - Mental Health (12 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions