neurocognitive II: delirium Flashcards

exam 2

1
Q

delirium is commonly seen on

A

inpatient medical/surgical units and in extended care facilities

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2
Q

delirium duration

A

last days to weeks

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3
Q

delirium is associated with poor outcomes

A
  • increased mortality
  • institutionalization
  • dementia
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4
Q

delirium is a disturbance in ____ and ____

A

attention and awareness

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5
Q

delirium clinical features

A
  1. acute onset
  2. fluctuating course “waxing and waning” lucid intervals
  3. inattention
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6
Q

psychomotor distubances in delirium

A
  1. hyperactive
  2. hypoactive
  3. mixed
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7
Q

hypoactive signs

A

harder to identify

- marked by lethargy

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8
Q

delirium can be cause by medications but especially

A

anticholinergics

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9
Q

anticholinergic syndrome

A

inhibition of Ach transmission in the parasympathetic nervous system (muscarininc)

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10
Q

subdural hematoma can present as a quiet _____ delirium

A

hypoactive

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11
Q

pathophysiology of delirium

A
  • Nt deficiency/ excess

- neuroinflammatory events

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12
Q

Nt in delirium

A
  1. decrease in Ach
  2. decrease in GABA
  3. increase in Glutamate
  4. increase in dopamine
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13
Q

eeg in delirium

A

diffuse slowing

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14
Q

delitium tremens

A

alcohol withdrawing

  • low voltage fast activity waves
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15
Q

hepatic encephalopathy

A

build up of ammonia

  • triphasic waves s
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16
Q

acute onset, remits with correction of underlying medical condition

A

delirium course

17
Q

slow onset, chronic progressive

A

dementia course

18
Q

memory impacientar

A

dementia

19
Q

fluctuating levels of consciousness with decreased attention

A

delirium

20
Q

is dementia a major risk factor for delirium?

A

yea

21
Q

what type of dementia can look like delirium due to fluctuating levels of arousal

A

lewy body dementia

22
Q

pharmacologic managment

A
  1. antypsychotics by decreasing severity and duration

2. cholinesterase inhibtor but does not really work

23
Q

pharmacological management usually during their

A

agitated state

24
Q

elirium is characterized by which of the following neurotransmitter changes?

  1. ↑ dopamine, ↑ Ach
  2. ↓ dopamine, ↓ Ach
  3. ↑ dopamine, ↓ Ach
  4. ↓ dopamine, ↑ Ach
A

3.↑ dopamine, ↓ Ach

25
Q

When the underlying medical abnormality causing delirium is successfully addressed, the associated cognitive difficulties will always fully resolve.

A

ideally it is true

26
Q

Patients with dementia are more likely to experience delirium than patients without dementia.

A

true

27
Q

Which class of medication is most likely to be helpful for severely agitated patients with delirium?

  1. Benzodiazepines
  2. Antidepressants
  3. Antipsychotics
  4. Cholinesterase inhibitors
A

3.Antipsychotics

28
Q

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.

A

true