Disorders of Cognition Flashcards
Cool fact about long term memory?
Unlimited capacity (things can be lost or only recalled with a certain trigger but no limit on amount of memory you can store)
What is involved in retrieving memories? And what else does it do?
Hippocampus
-Also converts them from short to long term memories
How many types of memory and what are they?
3 types
- Episodic
- Semantic
- Procedural
What is episodic memory?
Memory of experiences
What is semantic memory?
Memory of facts
-Don’t remember where you learnt facts just that you recall them
What is procedural memory?
Acquired memory through repeating tasks
- automatic
What is primary and recency effect?
Idea that when recalling items from a list we remember the start and the end best
What is delirium?
Acute deterioration in mental functioning arising over hours or days that is triggered mainly by acute medical illness, surgery, trauma or drugs
RF for delirium?
- Increased age
- Pre-existing cognitive impairment
- Post-op
- Sensory impairment
- Prev episode of delirium
- Drug/alcohol dependence
- Depression
- Polypharmacy
- Multiple comorbids
- ICU admission
Causes of delirium?
D: Drugs (benzos, narcotics, ACh)
E: Electrolyte disturbance (hyponatraemia)
L: Lack of drugs (withdrawal)
I: Infection (UTI, sepsis)
R: Reduced sensory input
I: Intracranial (stroke, subdural haemorrhage)
U: Urinary retention
M: Metabolic (AKI, hypoglycaemia, hypothyroid, B12, Ca)
Signs and symptoms of delirium?
- Acute onset
- Transient and fluctuating course of lucid intervals
- Lasts days to months depending on underlying cause
- Contrast to dementia which is slow and progressive
- Altered consciousness
- Inattention and impaired memory
- Emotional disturbance
- Sleep cycle reversed
- Insomnia
- Disturbing dreams and nightmares
- Disorientation
- Hallucinations and illusions
Types of delirium?
Hyperactive > agitated, aggressive, wandering, easy to diagnose
Hypoactive > withdrawn, apathetic, sleepy, coma, harder to diagnose but twice mortality rate
Screening for delirium?
- All ptnts over 65 should be screened on admission
- 4AT score
- Confusion assessment method (CAM)
4AT score?
Alertness
AMT4 (age, DOB, place, year)
Attention
Acute change or fluctuating course
Management of delirium?
TREAT UNDERLYING CAUSES
