First Aid Psychiatry: Neuro Flashcards
What is the ICU triad
delirium
pain
agitation
is delirium a medical emergency
yes
Most common precipitants of delirium in children are
febrile illness and medications
EEG for delirium
diffuse slow EEG
what does EEG show for delirium tremens
nothing
quick bedside am for substance/medication intoxication
VALEUMS vitals alertness Eyes Urine mucous membrane skin
what happens to memory in delirium
deficits in recent memory
What is used to rule diagnose delirium
Confusion Assessment Method
How is delirium treated
treat the underlying cause
drug of choice for Delirium
Haloperidol
what drugs are contraindicated in delirium
second generation antipsychotics
Benzodiazepines (only used in alcohol delirium)
Name 2 tests for diagnosis for neurocognitive disorder
Mini Mental State Exam
Mini-Cog
how does hyperthyroidism show in the elderly
apathetic thyrotoxicosis: depression and lethargy
Most common underlying etiology of major neurocognitive disorder
Alzheimer
cognitive domains impacted by Alzheimer
memory
learning
language
what is found in brain of Alzheimer
senile plaques and neurofibrillary tangles
- extraneural beta-amyloid plaques
- intraneural tau protein tangles
how does Alzheimer start
gradual cognitive decline
genes predisposing to Alzheimer
Amyloid precursor protein
presenilin 1
Presenilin 2
EPO4
treatment for Alzheimer
- Cholinesterase inhibitors
- NMDA receptor antagonist
- antipsychotics: increased mortality
antipsychotics carry a black box warning for what in patients with dementia
increased risk of death
how does vascular disease present
complex attention and executive function
- stepwise deterioation
- acute onset follow by partial improvement
- insidious onset with gradual decline
core features of Lewy Body
- waxing and waning of attention and alertness
- visual hallucinations
- extrapyramidal signs
Suggestive features of Lewy body
- REM sleep behavior disorder
- antipsychotic sensitivity
pathology of Lewy Body
Lewy bodies: alpha-synuclein
Lew Neurites
- both in basal ganglia
treatment Lewy Body
- cholinesterase inhibitor
- Quetiapine or clazapine
- levodopa/carbidopa
- Melatonin/clonazepam
clinical manifestation for Frontotemporal degeneration
cognitive deficits in attention, abstraction, planning, and problem solving
- difficult speech and comprehension
treatment for frontotermpaol degeneration
Serotnergic medications my help
name an infection that can cause neurocognitive deficiency
HIV
treatment of HIV
- Highly active antiretroviral therapy
- psychostimulants
Triad of Huntington clinical manifestation
- Motor: chore and bradykinesia
- cognitive: executive function
- psychiatric
Treatment of Huntington
Tentrabenzine or atypical antipsychotics
How is Parkinson’s diagnosed
- Bradykinesia : tremor or ridigity
- asymmetry of motor symptoms
- cognitive decline appears after onset of motor symptoms
treatment for Parkinsons
- carbidop/levodopa
- cholinesterase inhibitor
- Queitipine or clozapine (low dose)
symptoms of Parkinson’s disease can be exacerbated by what medication
antipsychotics
pathology of prion disease
spongiform encephalopathy
most common type of prion disease
Creutzfeldt-Jakob disease
clinical features of prion diseae
- rapid progression
- concentration, memory, and judgment first to go
- myoclonus
- ataxia, nystagmus, and hypokinesia
EEG for prion disease
periodic sharp wave complexes
lesions occur where in brain for prion disease
putamen or caudate nucleus
what does lumbar puncture show for normal pressure hydrocephalus
- normal opening pressure
- elevation of CSF
treatment for normal pressure hydrocephalus
shunt
