neurocognitive II: delirium Flashcards
exam 2
delirium is commonly seen on
inpatient medical/surgical units and in extended care facilities
delirium duration
last days to weeks
delirium is associated with poor outcomes
- increased mortality
- institutionalization
- dementia
delirium is a disturbance in ____ and ____
attention and awareness
delirium clinical features
- acute onset
- fluctuating course “waxing and waning” lucid intervals
- inattention
psychomotor distubances in delirium
- hyperactive
- hypoactive
- mixed
hypoactive signs
harder to identify
- marked by lethargy
delirium can be cause by medications but especially
anticholinergics
anticholinergic syndrome
inhibition of Ach transmission in the parasympathetic nervous system (muscarininc)
subdural hematoma can present as a quiet _____ delirium
hypoactive
pathophysiology of delirium
- Nt deficiency/ excess
- neuroinflammatory events
Nt in delirium
- decrease in Ach
- decrease in GABA
- increase in Glutamate
- increase in dopamine
eeg in delirium
diffuse slowing
delitium tremens
alcohol withdrawing
- low voltage fast activity waves
hepatic encephalopathy
build up of ammonia
- triphasic waves s
acute onset, remits with correction of underlying medical condition
delirium course
slow onset, chronic progressive
dementia course
memory impacientar
dementia
fluctuating levels of consciousness with decreased attention
delirium
is dementia a major risk factor for delirium?
yea
what type of dementia can look like delirium due to fluctuating levels of arousal
lewy body dementia
pharmacologic managment
- antypsychotics by decreasing severity and duration
2. cholinesterase inhibtor but does not really work
pharmacological management usually during their
agitated state
elirium is characterized by which of the following neurotransmitter changes?
- ↑ dopamine, ↑ Ach
- ↓ dopamine, ↓ Ach
- ↑ dopamine, ↓ Ach
- ↓ dopamine, ↑ Ach
3.↑ dopamine, ↓ Ach
When the underlying medical abnormality causing delirium is successfully addressed, the associated cognitive difficulties will always fully resolve.
ideally it is true
Patients with dementia are more likely to experience delirium than patients without dementia.
true
Which class of medication is most likely to be helpful for severely agitated patients with delirium?
- Benzodiazepines
- Antidepressants
- Antipsychotics
- Cholinesterase inhibitors
3.Antipsychotics
Symptoms of delirium often fluctuate over the course of the day leading observers to occasionally mistakenly believe the patient has conscious control over their symptoms.
true