NEUROCOGNITIVE DISORDERS Flashcards
Cognition includes memory, language, orientation, judgment,
conducting interpersonal relationships, performing actions
(praxis), and problem solving
remember 4
acute decline in both the level of
consciousness and cognition in short time and its reversible as well as rapid improvement when the causative factor is
identified and eliminated
hallmark symptom of delirium is an ————
impairment of consciousness,
The major neurotransmitter to be involved in delirium
is ——-
acetylcholine {decreased}
* Also dopamine increased in delirium.
major neuroanatomical area is the ————-
reticular
formation. (attention and arousal
1 percent of elderly persons age 55 years
———percent reported subsequent incidences of delirium during
hospitalization
———–percent of general surgical
patients
———–percent of open heart surgery patients, and more than
——–percent of patients treated for hip fractures(orthopedic surgery )
*** Delirium occurs in 70 to 87 percent of those in intensive care
5 to 30
10 to 15
30
50
most important risk factor in delirium
age >65 is the most contributing factor
clinical features of delirium
disorganization of thought processes (ranging from
mild tangentiality to frank incoherence).
* Perceptual disturbances such as illusions and
hallucinations.
* Psychomotor hyperactivity and hypoactivity.
* Disoriented to place or time (cognitive function)
* decrease attention (more distracted , decreased
short-term memory )
* Disruption of the sleep-wake cycle (often manifested as
fragmented sleep at night, with or without daytime
drowsiness).
* Mood alterations (from subtle irritability to obvious
dysphoria,anxiety, or even euphoria)
DSM 5 for delirium
1-attention and awareness deficit
2-over short period of time
3-cognitive decline (memory/language )
3-can be explained duo to another medical condition
delirium generally lasts
delirium usually recede over a 3- to 7-day period,
although some symptoms may take up to 2 weeks to resolve
completely.
less than 1 week
The 3-month mortality rate of patients who have an episode of delirium is
estimated to be 23 to 33 percent. The 1-year mortality rate for patients
who have an episode of delirium may be as high as————-
50 percent
psychotic Tx of delirium
haloperidol po r IM
insomnia treated by benzo
Reversible causes of dementia
Metabolic abnormalities (e.g., hypothyroidism)
* Nutritional deficiencies(e.g., vitamin B12, folate)
Dementia syndrome caused by depression
*(the most
common type of dementia ).
* Vascular dementia is the second most common type of dementia, account for
15 to 30 percent of all dementia cases
Alzheimer’s diseases accounts for 60 to 80 percent of cases.
dementia dsm 5
1-cognitive decline from prevoius level
2-not related to medical disorder
3-not related to delirium
4-interfere with independance daily activities
