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Pathopharmacology Fundamentals > Wk 4 Dementia & Delirium > Flashcards

Wk 4 Dementia & Delirium Flashcards

1
Q

Acute confusional state, aka organic brain syndrome

A

Delirium

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2
Q

Delirium is a transient disorder of… (3)

A

Cognitive function, consciousness, or perception

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3
Q

Delirium is typically acute and

A

associated with other medical conditions

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4
Q

__ withdrawal can contribute to delirium

A

Alcohol

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5
Q

Metabolic disorders such as __ can contribute to delirium

A

hypoglycemia

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6
Q

Increased accumulation of __ from liver or kidney failure can contribute to delirium

A

Metabolites

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7
Q

These three things can contribute to delirium

A

Brain surgery, tumors, trauma

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8
Q

Post __ can contribute to delirium

A

Anesthesia

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9
Q

These three states can contribute to delirium

A

Fever, electrolyte imbalances, dehydration

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10
Q

Acute disturbance in attention or awareness

A

Hyperactive delirium

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11
Q

Hyperactive delirium typically develops over

A

2-3 days

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12
Q

Hyperactive delirium is commonly seen in

A

ICUs, post op, withdrawal, and hospitalized elderly

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13
Q

Risk factors for hyperactive delirium

A

medications like bentos or narcotics, acute infection or sepsis, hypoxia, electrolyte and metabolic dysfunction, insomnia

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14
Q

Hyperactive delirium is related to…

A

Autonomic nervous system overactivity

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15
Q

What symptoms does someone with hyperactive delirium have?

A

Restless, irritable, can’t concentrate, can’t sleep, poor appetite, tremors

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16
Q

Severe delirium is called

A

Fully developed delirium

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17
Q

Patients with fully developed delirium

A

Hallucinate, completely inattentive, can’t pay attention to what’s going on, can’t rationalize, can’t be brought into reality, high levels of restless movement, dilated pupils, fever, diaphoretic

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18
Q

If can’t control developed delirium it can turn into

A

Excited delirium syndrome

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19
Q

Excited delirium syndrome: The patient becomes

A

Combative, aggressive, pain, tachypnea, can cause death!

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20
Q

Excited delirium syndrome most common in…

A

Mental illness or prior mental illness

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21
Q

Excited delirium syndrome less common in..

A

the elderly but it can occur

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22
Q

Treatment for excited delirium syndrome

A

Try to remove the risk factors, try to help them sleep, medications

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23
Q

Excited delirium syndrome usually resolves in

A

2-3 days, but can persist for weeks, especially if still hospitalized

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24
Q

Hypoactive delirium most associated with

A

right-sided frontal basal ganglion disruption

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25
Q

Hypoactive delirium affects the part of the brain associated with

A

Coordinated movements and alertness

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26
Q

Hypoactive delirium most common in metabolic disorders such as

A

Liver and kidney failure, build up of metabolites

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27
Q

Someone with hypoactive delirium presents with

A

Decreased alertness and attention span, decreased perception of the environment, slow speech, sleepy, apathetic

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28
Q

Hypoactive delirium aka

A

Catatonic

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29
Q

Goal to treat delirium

A

Identify cause and remove causative agents, modify risk factors when can

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30
Q

If a patient has dementia, they have a

A

much higher risk of becoming delirious

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31
Q

Delirium can be

A

prevented!

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32
Q

Can give __ for hyperactive delirium for the risk factors that we cannot do anything about

A

antipsychotics, these are short term treatments

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33
Q

If delirium persists for weeks…

A

It needs to be followed up by the HCP because it’s not delirium anymore

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34
Q

Delirium age

A

Usually older

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35
Q

Delirium onset

A

Actue, hospitalizations

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36
Q

Delirium associated conditions

A

UTI, thyroid disorder, hypoxia, hypoglycemia

37
Q

Delirium course

A

Fluctuating, reversible

38
Q

Duration of delirium

A

hours, days, sometimes months

39
Q

Delirium attention

A

Inability to focus or sustain attention

40
Q

Delirium sleep wake is

A

disrupted

41
Q

Behavior of someone with delirium

A

Agitated, withdrawn, depressed

42
Q

Speech pattern of someone with delirium

A

Incoherent, disorganized

43
Q

Thoughts and perceptions of someone with delirium

A

Disorganized, delusions, hallucinations

44
Q

Dementia is an…

A

Acquired deteriorated and progressive failure of cognitive function

45
Q

Dementia cognitive processes affected

A

Memory, language, judgement, decision making,

46
Q

Dementia patients may present

A

Agitated, frustration, wandering, aggression

47
Q

Pathophysiology of dementia

A

neuron degeneration, compression of brain tissue

48
Q

In dementia there is atherosclerosis

A

in cerebral vessels

49
Q

Possible causes of dementia

A

Brain trauma, infection, neural inflammation

50
Q

Two infections that can contribute to dementia

A

HIV and Cruetzfeldt Jakob disease

51
Q

Onset of dementia

A

Slow onset, irreversible

52
Q

Manifestations of dementia disease

A

Memory loss, decrease LOC, overall slowing

53
Q

No cure for dementia, treatment aimed at

A

Restoring and optimizing function, such as OT

54
Q

Alzheimer’s disease accounts for __ % of dementia

A

50-75%

55
Q

Vascular dementia accounts for __% of dementia

A

20-30%

56
Q

Lewy body dementia accounts for __% of dementia

A

10-25%

57
Q

Frontotemperal accounts for __% of dementia

A

10-15%

58
Q

A lot of dementia is

A

Mixed, can have more than one type at once

59
Q

Leading cause of severe dysfunction in the elderly

A

Alzheimer’s disease

60
Q

Being a woman makes you

A

much more likely to get Alzheimer’s disease, 2/3 are women

61
Q

Genetic Alzheimers associated with

A

early onset

62
Q

Sporadic late onset Alzheimer’s

A

Older age, more common, not exact genetic association

63
Q

Alzheimer’s is a

A

rule out disease

64
Q

Clinical criteria for Alzheimer’s disease

A

Mental status exam, brain imaging

65
Q

Risk factors for Alzheimer’s

A

Older than 65, family history, existing cognitive impairment, drinking, smoking, unhealthy diets, previous head trauma, and social isolation

66
Q

Alzheimer’s pathophysiology: Accumulation of

A

neuritic plaques (Amyloid) and intraneuronal neurofibrillary tangles of tau protein

67
Q

Alzheimer’s pathophysiology: Tau protein is a key factor that…

A

Accelerated nerve degeneration

68
Q

Alzheimer’s pathophysiology: Neuritic plaques disrupt

A

nerve impulse transmission and kill neurons

69
Q

Alzheimer’s pathophysiology: Neuritic plaques more centralized in the…

A

cerebral cortex and hippocampus, these are typically associated with memory

70
Q

Alzheimer’s pathophysiology: These contribute to memory and cognitive decline

A

Loss of synapses, decreased acetylcholine, and other neurotransmitters

71
Q

Alzheimer’s pathophysiology: Loss of neurons leads to

A

brain atrophy

72
Q

Alzheimer’s pathophysiology: All of these changes occur

A

decades prior to symptoms

73
Q

Initial manifestations of Alzheimer’s disease

A

Subtle, difficult to identify, typically progressively more difficult to remember current events

74
Q

Alzheimer’s patients eventually end up in a

A

Nonverbal vegetative state, and it leads to death

75
Q

Second most common type of dementia

A

Vascular, related to CVD

76
Q

Vascular dementia related to…

A

CVD, CAD, cardioembolism, small vessel disease, stroke… all causing hypoperfusion to the brain

77
Q

Risk factors for vascular dementia

A

DM, HTN, hyperlipidemia, smokers

78
Q

Treatment for vascular dementia

A

treat the risk factors

79
Q

Frontotemporal dementia

A

really, rare, used to be known as pick disease

80
Q

Age of onset for frontotemporal dementia

A

Less than 60

81
Q

Frontotemporal dementia is related to

A

Gene mutations of encoding the tau protein

82
Q

3 distinct clinical syndromes of frontotemporal dementia

A

Behavioral variant, progressive non-fluent behavior, semantic dementia

83
Q

Semantic dementia

A

Problems forming words and sentences

84
Q

Behavioral variant dementia

A

changes in personality

85
Q

Progressive non-fluent behavior dementia

A

Problems with language and writing skills

86
Q

How do you test for frontotemporal dementia?

A

Genetic testing

87
Q

Treatment for frontotemporal dementia

A

There is none

88
Q

Dementia onset

A

insidious and progressive

Pathopharmacology Fundamentals (13 decks)

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