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People and Illness Lectures > Organic Psychiatry > Flashcards

Organic Psychiatry Flashcards

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1
Q

what is cognition

A
  • Attention/orientation
  • Memory
  • Executive functioning
  • Language
  • Calculation
  • Praxis
  • Visuospatial ability
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2
Q

4 classifications of attention

A
  1. Arousal
  2. Sustained attention
  3. Divided attention
  4. Selective attention
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3
Q

abnormalities in attention can indicate

A

delirium

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4
Q

role of frontal lobes

A
  • Goal setting and motivation
  • Judgement and control of inhibition
  • Flexibility and problem solving
  • Planning/sequencing organisation
  • Abstract reasoning
  • Social behaviour personality
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5
Q

2 things that make delirium occur

A

Predisposing factors + precipitating factors (infection, stroke, drugs, MI, fractures, cancers)

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6
Q

3 main drug approaches to delirium

A

Antipsychotics

Benzodiazepines

Other

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7
Q

5 Antipsychotics

A

Haloperidol

Olanzapine

Risperidone

Aripiprazole

Quetiapine

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8
Q

2 Benzodiazepines

A

Lorazepam

Diazepam

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9
Q

3 other treatments for delirium

A

Specific treatment of underlying cause

Melatonin

Trazodone

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10
Q

Acalculia

A

inability to comprehend or write numbers properly

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11
Q

Anarithmetria

A

difficulty with arithmetic

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12
Q

where do calculations occur

A

left hemisphere

Angular gyrus in parietal lobe

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13
Q

3 stages of spectrum of cognitive impairment

A

Age related decline → mild cognitive impairment → dementia

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14
Q

list some Non-pharmacological approaches to delirium

A
  • Noise control and lighting
  • Orientating influences – calendars, clocks, familiar objects, family (reality orientation)
  • Fluid balance/diet/bowel habit/pain control
  • Regular communication/reassurance from staff.
  • Address sensory impairment
  • Limit variation in staff
  • Encourage normal sleep cycle and side room if possible
  • Early mobilising
  • Avoid ward transfers
  • Consider necessity of certain procedures
  • Recognise frailty
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15
Q

what is dementia

A
  • Syndrome with chronic, progressive (usually irreversible) cognitive impairment due to brain disease
  • Deterioration from higher level of function
  • No clouding of consciousness
  • Chronic duration > 6 months
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16
Q

8 causes of reversible dementia

A
  • B12, folate deficiency
  • Hypothyroidism
  • Hydrocephalus - subdural haematoma, CNS tumour
  • Wilson’s disease
  • Cerebral vasculitis
  • Depression ‘pseudo-dementia’
  • Whipple’s disease
  • Metabolic problems
17
Q

main psychotic differentials of dementia

A
  • Main psychiatric differentials
  • Normal ageing
  • Delirium
  • Mild cognitive impairment (MCI)
  • Amnesic syndromes
  • Chronic brain damage (eg head injury or anoxia)
  • Depression (pseudo-dementia)
  • Late onset schizophrenia or other psychosis
  • Learning disability
  • Malingering presentations
  • Dissociation
18
Q

hallmark features of dementia

A
  • Impaired consciousness
  • Hyperactive or hypoactive sub-type
  • Acute onset
  • Change in cognition
  • Cognitive deficits
  • Visual hallucinations (and other psychotic symptoms)
  • Sleep-wake cycle disruption
  • Affect changes
  • In most cases, evidence of an underlying direct cause
19
Q

main visuospatial deficits in dementia

A
  • Topographical disorientation
  • Difficulties with dressing (dressing apraxia)
  • Mis-reaching for objects
  • Visual neglect
  • Visual object agnosia
  • Prosopagnosia
20
Q

deficits in praxis

A

dyspraxia

21
Q

praxis is errors of

A
  • Action conception (knowledge of actions/item function)
  • Action production (production/control of movement)
22
Q

where does praxis occur

A

left hemisphere function – parietal and frontal lobe

23
Q

dianogisis of dementia

A
  • Clinical assessment
  • Corroborative history
  • General physical examination
  • Mental State Examination Standard (+/- specialised) bloods
  • Structured cognitive testing Structural (+/- functional) imaging
24
Q

lab investigations of dementia

A
  • FBC
  • ESR
  • CRP
  • Glucose
  • U+E
  • LFTs
  • Bone profile
  • TFTs
  • Urinalysis
  • MSSU B12
  • folate
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