Week 7 Flashcards
What is delirium
-An acute confused state with an sudden onset and a fluctuating state of awareness
-Commonly find cognitive changes such as impaired information processing, hallucinations, delusions, abnormal psychomotor activity (wild thrashing) disturbances of the sleep cycle
-May result from head injury, infection, drug intoxication, drug withdrawal, drug toxicity
What suggests poor prognosis after brain injury
- Patients general intellectual level considerably reduced
-Losses of adult social role functioning
-Posttraumatic epilepsy
-Dramatic personality changes
-Positivity, loss of drive and spontaneity, agitation, anxiety depression, and paranoid suspiciousness
What is Alzheimer’s disease
-Progressive and fatal neurodegenerative disorder
-Usually slow but progressively deteriorating course terminating in delirium and death
What are early signs of Alzheimer’s
-Withdrawal from active engagement, more self-centered and child-like (preoccupation with eating, digestion and excretion)
-More severe: impaired memory for recent events, empty speech, messiness, impaired judgment, agitation and periods of confusion
-Delusions (paranoid and jealous) and a combative pattern occur in some patients
-Death usually comes from lowered resistance to opportunistic infections.
Describe the course of Alzheimer’s
-Cell loss for instance of acetylcholine, neurotransmitter important for memory
-Amyloid plaques containing a sticky neurotoxic protein called beta amyloid
-Neurofibrillary tangles
-Contain abnormal tau protein which may be caused by accumulation of beta amyloid
How is Alzheimer’s diagnosed
- Diagnosis based on clinical assessment
-Blood test to assess beta amyloid levels
-MRI, CT, PET imaging
-Cerebrospinal fluid tests
-Neurological exams
-Neuropsychological tests
-Usually begins after age 45
-Gradual and slow mental deterioration with multiple cognitive deficits
What is the prevalence of Alzheimers
-1-2% of population between 65 and 74; about 30% of population over 85
-Woman have a slightly higher risk
-Self reported loneliness doubles risk
-High-fat, high-cholesterol diet may play a part due to lower rates seen in Japan, Nigeria, India
-High levels of an amino acid homocysteine increases risk for AD and heart disease
What are the 3 different types of head injuries
Penetrating or open head injury
Object pierces the skull and enters the brain tissue
Damages part of the brain
Non-penetrating or closed head injury
Caused by an external force strong enough to move the brain within the skull
Causes include falls, motor vehicle crashes, sports injuries, blast injury, or being struck by an object
Phineas Gage
What is the most common cause of traumatic brain injury?
Falls, blunt trauma, accidents, vehicular injuries, assaults/violence, explosions/blasts
What is vascular dementia?
A series of circumscribed cerebral infarcts cumulatively destroy neurons over expanding brain regions
Tends to occur after 50; more common in men
Accounts for about 1& of all dementia cases; patients are more vulnerable to sudden death from stroke or cardiovascular event
Accompanying mood disorders more common than in AD
Cerebral arteriosclerosis can be medically managed to some extent
What are the causes of focal brain damage
Damage from an injury or stroke
What are the first signs of neurocognitive disorders (12)
Cognitive changes (mood or personality changes)
Changes in cognitive function
Anosognosia: a condition where impairment may extend to the capacity for realistic self-appraisal (they do not know what they were like before the accident)
Impairment of memory
Impairment of orientation
Impairment of learning
Impairment of emotional control or modulation
Apathy or emotional blunting
Impairment in the initiation of behavior
Impairment of controls over matters of propriety and ethical conduct
Impairment of receptive and expressive communication
Impaired visuospatial ability
What is parkinson’s disease
second most common neurodegenerative disorder
Age is a risk factor for
More common in men
Characterized by motor symptoms such as tremors or rigid movement muscle stiffness slowed movement and poor coordination
Underlying cause is loss of dopamine neurons in the basal ganglia, loss of norepinephrine: development levy bodies
About 75% develop dementia later
Symptoms temporarily relieved by medications levodopa, new treatments include
What is huntington’s disease
rare degenerative disorder
Mean age of onset is 40 affects men and women equally
Characterized by w chronic progressive choreas (involuntary and irregular movements that flow randomly from one area of the body to the other
Eventually develop dementia
Death typically occurs within 10 to 20 years of first symptoms
Caused by an autosomal dominant gene of chromosome 4
What are the neurocognitive problems associated with AIDS
presence of the HIV-1 virus could itself result in the destruction of brain cells
May lead to the emergence of psychotic phenomena
Virus causes generalized atrophy, edema, inflammation, and patches of demyelination
Damage may occur throughout brain but seems to be localized in eubcorticsl regions notably the white matter the tissue sure
