First Aid for the Psychiatry Clerkship - "Neurocognitive Disorders" Flashcards
Put simply, neurocognitive disorders are defined by ____________________.
a decline in cognitive function from baseline
List the five categories of delirium that are in the DSM-5.
■ Substance intoxication delirium ■ Substance withdrawal delirium ■ Medication-induced delirium ■ Delirium due to another medical condition ■ Delirium due to multiple etiologies
You are called to assess delirium in an elderly patient in a nursing home. You suspect a medication might have caused it. What is First Aid’s mnemonic for assessing drug-induced delirium?
VALEUMS: ■ Vital signs ■ Alertness Level ■ Eyes (pupil size and position) ■ Urine (bladder distension or incontinence) ■ Mucous membranes (moisture) ■ Skin (temperature and moisture)
The most common type of delirium is ___________________.
mixed type, in which the person fluctuates between hyperactivity and hypoactivity
____________ delirium is more likely to go undetected.
Hypoactive
What are the DSM-5 criteria for delirium?
- Alterations in attention and awareness
- Impairment in at least one additional cognitive domain (like memory)
- Not due to another neurocognitive disorder
- Evidence that suggests the impairment is due to a medication, abnormal lab value, or medical stressor
- Acute development
What’s the difference between being lethargic and being stuporous?
Lethargy means you are drowsy but can be aroused, while stupor means you are drowsy and cannot be aroused.
True or false: benzodiazepines can help treat agitated patients with delirium.
False. Benzodiazepines generally worsen delirium. The only exception is in delirium due to alcohol withdrawal.
What five categories of testing does the Mini Mental State Exam test?
L ROAR
- Language (naming objects, repeating a short sentence, writing a sentence, reading a sentence)
- Recall (three objects after five minutes)
- Orientation
- Attention (serial 7’s)
- Registration (three objects immediately)
What is the Mini-Cog test?
The Mini-Cog test is a three-item recall and a clock drawing. A positive screen is an abnormal drawing and no items recalled at three minutes.
The three primary domains affected in Alzheimer’s dementia are _______________.
language, learning, and memory
Cholinesterase inhibitors are effective at ____________________ Alzheimer’s disease.
delaying the deterioration
NMDA antagonists like _____________ have been shown to provide a modest benefit to those with Alzheimer’s.
memantine
_____________ should not be given to those with Alzheimer’s for extended periods because they are associated with increased mortality.
Antipsychotics
Any treatment plan for Alzheimer’s should include ___________ support.
caregiver
