Organic Psychiatry Flashcards
What is delirium?
It is an acute and transient state of global brain dysfunction with “clouding of consciousness”
What is the prevalence of delirium in the hospital?
20% of all patients
Up to 80% of ITU patients (trauma, hypoxia, infective, medication Induced)
15-56% of over 65 year olds
What does the clinical picture of delirium look like?
Sudden onset,
symptoms are worse at night
Impaired consciousness with poor attention, disorganised thinking and poor short term memory.
Mood changes are common (hyperactive/agitated or hypoactive/withdrawn)
Illusions and hallucinations (mainly visual)
Which investigations to do in someone with delerium?
Fbc, u&e, glucose, ca2+, msu, sa02, ecg, CXR, septic screen.
Consider: lft, blood cultures, ct head, csf, eeg.
Think about cause: delirium etiology checklist.
What’s the criteria for diagnosing delirium?
Dsm-v
1) disturbed level of awareness and attention
2) a change in cognition
3) evidence the disturbance is caused by a general medical condition
4) develops over a short period of time, and fluctuates in severity during the day
What is Kluver-Bucky syndrome?
Syndrome caused bilateral medical temporal lobe lesions. Presentation: hyperphagia(eats inappropriate objects/over eating), hypersexuality, visual agnosia(an able to recognise familiar things or people), amnesia, placidity.
What’s Capgras delusion?
Delusion that a friend or family member has been ‘replaced with an identical looking imposter’
What is a monothmatic delusion and some examples?
Only concerns one topic (often organic)
- capgras delusion: some one close has been replaced by an imposter
- fregoli delusions: various people are the same person in disguise.
- subjective doubles: there’s a clone of themselves carrying out independent actions
- lycanthropy: can transform into an animal
- somatoparapherenia: denies ownership of a limb or entire side of body.
What part of the brain is responsible for arousal and attention?
Ascending reticular activating system
What part of the brain is responsible for memory?
Limbic and diencephalon
What part of the brain is responsible for executive function?
Frontal lobes And cortico-striata-thalamo-cortical loops
Which area of the brain is effected in expressive and receptive dysphasia?
Expressive - brocas
Receptive - wernickes
What are the three types of frontotemporal lobar degeneration syndromes?
Frontotemporal dementia- disinhibition, social or personality changes.
Semantic dementia - progressive loss of understanding of verbal and visual meaning
Progressive non-fluent aphasia: naming difficulties and progresses to mutism
Usually between 40-60 years old
What is huntingtons disease?
AD disease causing dementia and chorea.
Deposits of the Huntingtin protein in basal ganglia and thalamus, plus frontal neuronal loss. And caudate nucleus atrophy
What’s the inheritance of Huntington’s disease?
Autosomal dominant
Trinucleotide repeats CAG on c.4
Has ‘anticipation’
