Organic mental disorders Flashcards
MMSE abbreviation
Mini mental state examination
Organic mental disorders definition
Decreased mental function due to a physical disease
Disturbances of consciousness
1) Examination of vigilance of consciousness (arausability)
- differentiation of drowsiness, somnolence, sopor, coma
2) Examination of integration of consciousness
3) Interaction of vigilance and integration
Disturbances of attention
1) Examination of vigilance of attention
2) Examination of tenacity of attention
Examination of orientation
1) Autopsychic orientation (personal data)
2) Allopsychic orientation
- orientation in place (city, street, building, etc.)
- orientation in time (year, month, date, season, etc.)
- recognising the situation
3) Confabulation
Confabulation
“Lying” about memories when actually cannot remember
Examination of memory
1) Memory types
- working memory
- short-term memory (teaching new information)
- long-term memory (data of personal life)
2) Mechanism of memory
- encoding/learning (teaching new information)
- storage (data of life history)
- retrieval (helps in recall)
Examination of intelligence
1) Global cognitive performance
2) (IQ measure – psychological competence)
3) Intelligence below normal
- Mental retardation (born with)
- Dementia (acquired)
Delirium symptoms
1) Disturbance of consciousness
- Vigilance and integration problems
2) Disturbance of attention
3) Perception disturbance
4) Global disturbance of cognitive processes (orientation, memory etc.)
5) Disturbance of psychomotorium, e.g. agitation etc.
6) Hypoactive, hyperactive, mixed form
7) Disturbance of the sleep-wake cycle
8) Emotional disturbances
Delirium course of disease
- Acute start
- Symptoms change during day
Delirium etiology
1) Metabolic disorders
- Hypoxia, glucose, electrolytes, anemia, endocrine etc
2) Alcohol, medicines, drugs
3) CV diseases
4) Nervous system disorders
5) Trauma
6) Complex etiology
Delirium vs dementia
1) Time period
2) Disturbances of consciousness
3) Other circumstances of development (e.g location)
4) Changes of symptoms
Dementia symptoms
1) Cognitive symptoms
- attention, orientation, memory, counting, reading, writing, speech, abstraction, insight, judgement, executive functions, cortical symptoms, vizuospatial activity, etc.
2) Behavioural symptoms (= non-cognitive symptoms, BPSD symptoms)
- delusions, hallucinations, mood disturbances, agitation, agressivity, anxiety, psychomotor symptoms, apathy, etc.
Classifications of dementia
1) Based on severity
2) Based on symptomatology
3) Based on etiology
Classification of dementia
- based on: severity
1) Mild cognitive impairment (MCI)
2) Mild dementia (MMS: 20-24)
3) Moderate dementia (MMS: 10-20)
4) Severe dementia (MMS: below 10)
Classification of dementia
- based on: symptomatology
1) Cortical dementia (cortical symptoms)
2) Subcortical dementia (psychomotor symptoms, executive dysfunction)
Classification of dementia
- based on: etiology
1) Primary neurodegenerative dementias (e.g. Alzheimer’s disease)
2) Secondary dementias (e.g. vascular dementia)
Diagnosis of dementia
1) Clinical picture
2) Labs
3) Imaging (MRI)
4) Cognitive tests
- MMSE
- Clock drawing test
5) Other
Old age psychiatry “3D-s”
- Dementia
- Depression
- Delirium
1A patient is sleepy, looks a little inattentive. His gait is mildly unstable and has difficulties in focusing on the examiner. He does not fall asleep while unattended. What is the name of this kind of alteration of consciousness?
- Drowsiness
- Somnolence
- Sopor
- Coma
Drowsiness
- A patient with severe depression is engaged with his negative thoughts and he is difficult to distract from them. What is the name of this kind of alteration of attention?
- Hyperprosexia
- Hypoprosexia
- Hypervigility-hipotenacy
- Hypovigility-hipertenacy
- Aprosexia
Hypovigility-hipertenacy
- A patient is able to tell his personal data, is aware of the actual year and the season. However he is not able to tell the exact date and month. He is correct regarding the city and the street of the place of the examination, on the other hand, instead of recognising that he is in a hospital, he says that we are in the town hall. What is the most correct description of the patient’s symptoms?
- Auto- and allopsychic disorientation
- Autopsychic disorientation, preserved orientation in time and place
- Preserved autopsychic orientation, partial orientation in time, disorientation in place, confabulation
- Preserved autopsychic oriantation, disorientation in time and place
- Partial auto-and allopsychic disorientation
Preserved autopsychic orientation, partial orientation in time, disorientation in place, confabulation
- Dementia can be diagnosed in the following condition:
- Severe decline of one cognitive domain, with impairment of everyday functioning
- Decline of multiple cognitive domains, with preserved everyday functioning
- Decline of one cognitive domain, with preserved everyday functioning
- Mild decline of multiple cognitive domains, with impairment of everyday functioning
Mild decline of multiple cognitive domains, with impairment of everyday functioning
5. Disconcertment is observed at a 60-year-old male patient under sick-ward conditions, he also has fever Possible diagnosis: - Organic hallucinosis - Dementia - Organic paranoid disorder - Delirium - Organic anxiety disorder
Delirium
