Depression, Dementia, Delirium

Question 1

Symptom that depression, delirium, dementia have in common

Answer 1

confusion

Question 2

Major causes of delirium

Answer 2

underlying medical condition, substance intoxication or withdrawal

Question 3

In what population of hospitalized patients is delirium most common?

Answer 3

post-op

Question 4

Considered a medical emergency. Is reversible

Answer 4

delirium

Question 5

fundamental information to the interpretation and use of all other information we collect

Answer 5

mental status

Question 6

Deficiencies that can cause delirium

Answer 6

thaimine, niacin, B12

Question 7

heavy metals that can cause delirium

Answer 7

lead, manganese, mercury

Question 8

What does asterixis suggest in association with delirium?

Answer 8

metabolic encephalopathy

Question 9

What do focal neuro signs suggest in association with delirium?

Answer 9

tumor or subdural hematoma

Question 10

Used to treat behavorial disturbances due to delirium

Answer 10

haldol or ativan

Question 11

Commonly used drug classes that can cause delirium

Answer 11

benzos, antidepressants, anticholinergics, NSAIDs

Question 12

Dementia syndrome that is characterized by urinary incontinence and gait apraxia

Answer 12

normal pressure hydrocephalus

Question 13

Dementia syndrome characterized by changes in personality/behavior including poor impulse control

Answer 13

frontotemporal dementia (Pick’s disease)

Question 14

A syndrome characterized by decline in memory and at least one other cognitive function sufficient to impair performance of everyday activities in an alert person

Answer 14

dementia

Question 15

What is the rate of progression for age-associated memory impairment?

Answer 15

1-2% per year

Question 16

Dementia syndrome characterized by memory impairment plus either: aphasia, apraxia, agnosia, loss of executive functioning

Answer 16

alzheimer’s

Question 17

difficulty remembering words to losing the ability to speak, read, or write

Answer 17

aphasia

Question 18

The inability to draw or construct simple configurations, such as intersecting pentagons. Performing a multistep task in the wrong order: buttering toast before putting it in the toaster.

Answer 18

apraxia

Question 19

loss of ability to recognize objects, persons, sounds, shapes, or smells

Answer 19

agnosia

Question 20

Pathophysiology suspected to be involved with Alzheimer’s

Answer 20

beta amyloid plaques, tau neurofibrillary tangles, and loss of connection between nerve cells

Question 21

Describe the severity of dementia results for MMSE scores

Answer 21

Mild (20-24), Moderate (13-19), Severe (less 12)

Question 22

If a patient has dementia and hypertension what should you consider as a possible etiology?

Answer 22

multi-infarct

Question 23

Cholinestarase inhibitors for Alzheimer’s

Answer 23

Aricept or Exelon

Question 24

Pharm treatment for Alzheimer’s that can regulate excess glutamate

Answer 24

Namenda

Question 25

Depression meds appropriate for Alzheimer’s patients

Answer 25

SSRIs or Wellbutrin

Question 26

Medication appropriate for Alzheimer’s patients for agitation, aggressiveness

Answer 26

Valproic acid, zyprexa, seraquel

Question 27

Medication appropriate for insomnia/sundowning in Alzheimer’s patients

Answer 27

trazadone

Question 28

a plan indicating preference for future healthcare decisions if you are unable to make decisions

Answer 28

advance directive

Question 29

agent to make all decisions regarding health care, including choices regarding health care providers, medical treatment and end of life decisions

Answer 29

Durable Power of Attorney for Health Care

Question 30

instructions that tell physicians and family members what life-sustaining treatment one does or does not want in the future if not able to make decisions

Answer 30

living will

Question 31

Medication you should avoid in depressed elderly patient because it can cause delirium

Answer 31

elavil (amitriptyline)