Organic conditions Flashcards
Etiology [3]
Acquired
Primary brain disorder
Secondary brain disorder
4 features of organic mental disorders
Cognitive impairment
Behavioural abnormalities
Mood changes
Psychotic features
3 subacute/acute organic mental disorders
Delirium
Organic mood disorder
Organic psychotic disorders
3 chronic organic mental disorders
Dementia
Amnesic syndrome
Organic personality change
Learning disability is defined as a condition of arrested development of the mind, skill impairment and contributing to overall level of intelligence - manifesting during developmental period. Criteria [3]
Intellectual impairment IQ < 70
Social adaptive dysfunction - deficits in 2 or more
Onset in developmental period - before 18 yo
Etiology of learning disability Genetic causes Single gene disorder [3] Microdeletion [3] Chromosomal abnormality [1]
Single gene disorders:
Fragile x
PKU
Retts syndrome
Microdeletion:
Digeorge
Prader-wili
Angelman syndrome
Chromosomal abnormality: Down syndrome
Etiology of learning disability
Infective [3]
Toxic [1]
Trauma [2]
Infective - rubella, meningitis, encephalitis
Toxic - FAS
Trauma - birth asphyxia, head injury
4 D’s in memory impairment in cognitive impairment in dementia
Psychiatric sx of dementia
Dysphaxia
Dyspraxia
Dysnogsia
Dysexecutive functioning
Psychosis Depression Agitation, anxiety Altered circadian rhythms Diaschisis
Rx (dementia) [6]
Acetylcholinesterase inhibitors Memantine Antipsychotics- Neuroleptics Antidepressants Anxiolytics but falls risk Anticonvulsants
Depression in elderly
Clinical features
Less [2]
More [4]
○ Less depressed mood, expressed suicidal wishes
More: insomnia, hypochondriasis, suicide, agitation
Late onset schizophrenia like psychosis Presenting age Clinical feature [1] Causes [2] Mx [3]
Presenting age: 65 yo Clinical features - persecutory delusions Cause: sensory loss, social isolation Mx: - Compulsory admission - Neuroleptics - Increased social contact
Side effects of acetylcholinesterase inhibitors [3]
Nausea
Vomiting
Diarrhea
Side effects of acetylcholinesterase inhibitors [3]
Nausea
Vomiting
Diarrhea
FTD features include behavioral disorders such as personality changes
Onset
Feature of early presentation
Speech disorder [3]
Neuropsychology features [1] and [2] that are preserved
Neurological signs [3]
Onset: early
Early presentation: emotional blunting
Speech disorder: altered output
stereotypy
echolalia
Neuropsychology [3] Frontal dysexecutive syndrome Preserved - Memory - Visuospatial function
Neurological signs
Parkinsonism
MND
Incontinence
Define delirium [3]
Transient organic mental syndrome
of acute/subacute onset
characterized by global cognitive impairment
Describe presenting features of delirium [3]
other than those described under general organic mental disorders
Fluctuating levels of arousal
Disordered sleep and wake cycle
Diorganised thinking
State the 6 aspects of cognitive impairment that can be affected in organic mental disorders
Orientation in time person and place Attention Memory Language Judgment Insight
Cause of delirium can be many and multifactorial
D- Drugs, dehydration, detox, deficiencies, discomfort (pain)
E- Electrolytes, elimination abnormalities, environment
L- Lungs (hypoxia), liver, lack of sleep, long ED stay
I- Infection, iatrogenic events, infarction (cardiac, cerebral)
R- Restraints, restricted movement/mobility, renal failure
I- Injury, impaired sensory input, intoxication
U- UTI, unfamiliar environment
M- Metabolic abnormalities (glucose, thyroid), metastasis (brain), medications
Name 5 medication that can cause delirium
Which is the commonest cause of delirium
Steroids * Opioids BDZ Carbamazepine TCAs
Dementia
Define [1]
Types [7]
A chronic syndrome characterised by global cognitive impairment
Types AD Vascular -stroke LBD FTD Huntington's chorea PD Head injury
Amnesic Syndrome
Describe how memory is affected [3]
Which types of memory are preserved [4]
Anterograde amnesia and retrograde amnesia with temporal gradient present
Episodic memory
Preserved:
- Global intellectual abilities
- Registration
- Working memory
- Procedural memory
State 6 examples of hippocampal damage causing dementia
HSV encephalitis Anoxia Surgical removal of temporal lobes Bilateral posterior cerebral artery occlusion Closed head injury Early AD
State 4 examples of diencephalic damage causing dementia
Korsakoff’s syndrome
Third ventricle tumours/cysts
Bilateral thalamic infarction
Post SAH
