Neruo: neurocognitive Disorders Flashcards
acute, abrupt, transient confused state
- due to an identifiable cause
- explain the AMS
- recovery?
delirium
Causes: meds, infections, electrolyte disturbs, CNS injury, uremia, organ failure, drugs, ETOH intox or withdrawl,
AMS flucctuates
recovery: usually FULL in 1 week
is dementia a disease or rather the result of specific diseaes?
it is result of specific diseases—esp ones involving cerebral cortex, subcortical connections or both
define dementia
used to desc intellectual and cognitive degeneration of sufficient severity that interferes with normal functioning
- can affect multiple aspects of cognitive function:
- memory
- orientation
- perception
- language
- higher exec function
Before you diagnose anyone with dementia, you must rule out four important things:
normal aging
delirium
depression
drug intox
There are three “categories” of cognitive dysfunction:
- normal aging–minor alerations in neuro funct
- MCI–mild cognitive impairment
- Dementia
explain mild cognitive impairment (MCI)
deficits that are more severe than are customarily seen with normal aging—-but insufficiently pronounced to diagnose dementia
Occasionally forgets appoitnsmens/ names Occasional errors w numbers sometimes needs help using new devices temporary confusion about the day of the week vision changes from cataracts sometimes forget the correct word retraces steps to find lost items occasionally makes poor decision sometimes weary of obligations annoyancce at disruption of routine
NORMAL AGING in HEALTHY brain
Noticeably dissruptive memory loss inability to concentrate on instructions diff with familiar daily tasks loses track of time and place diff understanding vision or space cant' follow a conversation misplaces things and blames others decreased or poor judgement withdraws from favoirte social activities personality and mood changes
DEMENTIA WARNING SIGNS
a state in which the level of consciousness is depressed, but to a lesser extent than a coma.
delirium
dementia is umbrella term to describe:
- alzheimers——MC in PTs >65
- Vascular dementia—20-30% of PTs >65
- Frontotemporal dementia
- Lewy Body Disease
- Parkinson
PTs 45 and younger, the MCC of dementia are:
PTs 65 and older, the MCC of dementia are:
45and younger Huntington MS lupus infectious
65+: AZ VASC dementia Frontotemp dementia lewy body PD
is PT aware of cognitive deteroiration with dementia?
no!!!!!
Most imp part of diagnosis for dementia?
clinical hx—-reports given by fam, care givers, etc
+
very detailed Mental status exam
General s/s for dementia:
memory loss abnormalities of speech diff with problem solving and abtract thinking impaired judgment personality changes emotional lability
MC type of dementia
Alzheimer
Epidemiology for Alzhimer
1/9 people over age 65 have it
6 million ppl in US
RF for Alzhiemer
increasing age
genetics
fam hx
severe head trauma
etiology/patho for alzhiemer
3 hypothesis: depositions of diff proteins cause brain issues:
- Amyloid beta protein deposition (senile plaques)
- Tau proteins–neurofibrillary tangles
- ACH deficiency leads to memory language and visuspatical chagnes
neruofibrillary tangles?
tau proteins
senile plaques?
amyloid beta proteins
CM for alzhimer
progression thought to comprise of pre-symptomatic phase of up to about 10 years and then a symptomatic pd of ten yeasr
asympto pd in alzhiemer caused by?
amyloid plauqes
sympto pd in alzhimer is caused by?
tau proteins
Early CM for alzhier
impairment of recent memory—may only be noticed by fam
