Memory & Cognition Flashcards
What is the NT change w/ Anxiety?
- Dec NE
- Inc GABA
- Dec serotonin (5-HT)
What are the NT changes w/ Depression?
- Dec NE
- Dec serotonin (5-HT)
- Dec dopamine
What are the NT changes w/ Alzheimer’s?
Dech ACh, NE & Glutamate
What are the NT changes w/ Huntington’s?
- Dec GABA
- Dec ACh
- Inc dopamine
What are the NT changes w/ Schizophrenia?
Inc Dopamine
What are the NT changes w/ Parkinson’s dz?
- Dec dopamine
- Inc serotonin
- Inc ACh
What is Orientation?
Pt’s ability to know who & where he/she is & the date/time
What are the common causes of loss of orientation?
- Alcohol
- Drugs
- Fluid/electrolyte imbalance
- Head trauma
- Hypogylcemia
- Nutritional deficiencies
What is the order of loss of orientation?
- Time
- Place
- Person
What is Retrograde amnesia?
Inability to remember things taht occured before a CNS insult
What is Anterograde amnesia?
Inability to remember things that occured AFTER a CNS insult (no new memory)
What is Korsakoff’s amnesia?
Classic anterograde amnesia caused by Thiamine (B1) def & assoc destruction of mamillary bodies. May also have retrograde amnesia
What is Korsakoff’s amnesia assoc w/?
Alcoholics & confabulations
What is Dissociative amnesia?
Inability to recall important personal info, usually subsequent to severe trauma or stress
What is a Cognitive disorder?
Significant change in cognition from previous level of functioning
(Delirium & dementia)
What is cognition?
Memor, attention, language & judgement
What are cognitive disorers assoc w/?
- ABN in CNS
- General medical cond
- Medications
- Substance use
What is Delirium?
Waxing & waning level of consciousness w/ acute onset; rapid dec in attention span & level of arousal
What is Delirium characterized by?
- Disorganzied thinking
- Hallucinations (often visual)
- Illusions
- Misperceptions
- Disturbance in sleep-wake cycle
- Cognitive dysfunction
Delirium is usually 2° to ____ ____.
Other illness
What is the MC presentation of altered mental status in an inpatient setting?
Delirium
What are the tech features of Delirium?
ABN EEG
What is the tx for Delirium?
- Identify & address underlying cause
- Optimize brain cond
- Antipsychotics (haloperidol)
What is Dementia?
Gradual dec in intellectual ability of “cognition” w/o affecting level of consciousness
What is Dementia characterized by?
- Memory deficits
- Aphasia
- Apraxia
- Agnosia
- Loss of abstract thought
- Behavioral/personality changes
- Impaired judgement
What can Dementia pts develop?
Delirium
What causes Dementia?
- Alzheimer’s dz
- Cerebral vascular infarcts
- HIV
- Pick’s dz
- Chronic substance abuse
- Creutzfeldt-Jakob dz
- NPH
What does Dementia inc w/?
Age
What are the tech features of Dementia?
Normal EEG
What is Psychotic disorder?
A distorted perception of reality (psychosis) characterized by delusions, hallucinations &/o disorganized thinking
Who can psychosis be present in?
Pts w/ medical illness, psychiatric illness or both
What are the signs of psychosis?
- Hallucinations
- Delusions
- Disorganized speech
What are Hallucinations?
Perceptions in the absence of external stimuli
What are Delusions?
False beliefs about oneself or others that persist despite the facts
What is Disorganized speech?
Words & ideas are strung together based on sounds, puns or “loose associations”
What are the different types of Hallucination?
- Visual
- Auditory
- Olfactory
- Gustatory
- Tactile
- Hypagogic
- Hypnopompic
What are Visual Hallucinations?
MC a feature of medical illness than psychiatric illness
What are Auditory Hallucinations?
MC a feature of psychiatric illness than medical illness
What are Olfactory Hallucinations?
Often occur as an aura of psychomotor epilepsy & in brain tumors
What are Gustatory Hallucinations?
Rare
What are Tactile Hallucinations?
Common in alcohol withdrawal & cocaine abusers
What are Hypagogic Hallucinations?
Occurs while going to sleep
What are Hypnopompic Hallucinations?
Occurs while waking from sleep
What is Schizophrenia?
Chronic mental disorder w/ periods of psychosis, disturbed behavior & thought, & decline in fucntioning lasts >6 mo
What is Schizophrenia assoc w/?
Inc dopaminergic activity & dec dendritic branching
Dx of Schizophrenia requires 2 or more of the following sx:
- Delusions
- Hallucinations- often auditory
- Disorganized speech (loose assoc)
- Disorganized or catatonic behavior
- Negative sx
What are the Negative sx?
- Flat affect
- Social withdrawal
- Lack of motivation
- Lack of speech or thought
What are the 5 subtypes of Schizophrenia?
- Paranoid (delusions)
- Disorganized (w/ regard to speech, behavior & affect)
- Catatonic (automatisms)
- Undiff (elements of all types)
- Residual
What is Brief psychotic disorder?
<1 month usually stress related
What is the duration Schizophreniform disorder?
1-6 months
What is Schizoaffective disorder?
At least 2 weeks of stable mood w/ psychotic sx, plus a major depressive, manic or mixed (both) episode
What are the 2 subyptes of Schizoaffective disorder?
Bipolar or Depressive
What contributes to the etiology of Schizophrenia?
Genetics & environment
What is assoc w/ psychosis/schizophrenia in teens?
Frequent cannabis use
Who gets Schizophrenia?
- Males=females
- Blacks=whites
- Presents earlier in men (teens to 20s)
- Women (20 to 30s)
What are Schizophrenic pts at risk for?
Inc risk of suicide
What is Delusional disorder?
Fixed, persistent, nonbizarre belief system lasting >1 month. Functioning otherwise not impaired
What is Share psychotic disorder (folie à deux)?
Development of delusions in a person in a close relationship w/ someone w/ delusional disorder
What is the prognosis of Shared psychotic disorder?
Often resolves upon separation
