Psych path 2 Flashcards
Orientation (loss of)
Common causes:
alcohol, drug, fluid/electrolyte, head trauma, hypoglycemia, nutritional
Order of loss: 1st time, 2nd place, 3rd person
Amnesia: retrograde
Can’t remember anything before CNS insult
Amnesia: anterograde
Can’t remember anything after CNS insult
Amnesia: Korsakoff
Classic anterograde amnesia caused by B1 deficiency and associated destruction of mammillary body.
Many also include retrograde amnesia
Amnesia: dissociative
In ability to recall important personal information, usually subsequent to severe trauma or stress.
“James Borne”
Cognitive disorder
Significant change in cognition (memory, attention, language, judgment) from previous level of functioning.
Associated with abnormalities in CNS, a general medication condition, medications, or substance abuse.
Includes delirium and dementia
Cognitive disorder: delirium
Waxing and waning level of consciousness with acute onset
Rapid decrease in attention span and level of arousal
Characterized by disorganized thinking, hallucination, illusion, misperceptions, disturbances in sleep wake cycle, cognitive dysfunction.
Ususally 2/2 other illness (CNS disease, infection, trauma, substance abuse/withdrawal)
Most common in inpatient setting: ABNORMAL EEG
Treat: treat underlying condition, optimize brain function,
antipsychotic (haloperidol)
Check for anticholinergic effects
Tolerate, anticipiate, dont agitate (TADA)
Dementia
Gradual decrease in intellectual ability or cognition without affecting level of consciousness.
Memory deficit, aphasia, apraxia, agnosia, loss of abstract thought, behavioral/personality changes, impaired jugdement.
Patient with dementia can develop delirium
Causes: alzheimer’s, cerebral vascular infarct, HIV, Pick’s, chronic substance abuse, CJD, NPH
Increase with age, but NORMAL EEG
In elderly patients, depression may present like dementia (pseudodementia)
Psychogenic disorder
Distorted perception of reality (psychosis) characterized by delusions, hallucinations, and or disorganized thinking.
Can occur in pts with medical illness, pyschiatric illness or both.
Signs of psychosis
1) Hallucination: perception in the absence of ext stimuli
2) Delusion: false belief about onself or others despite the fact (CIA is spying on you)
3) Disorganized speech: words and idea strung together based on sound, puns, or loose association
Hallucination types: visual
Most commonly medical illness
drug intoxication > psychiatric
Hallucination types: auditory
Most commonly psychiatric illness
psychiatric (schizo)> drug intoxication >
Hallucination types: olfactory
Occurs as an aura of psychomotor epilepsy and in brain tumors
Hallucination types: gustatory
rare
Hallucination types: tactile
Most commonly alcohol withdrawal;
-formication: sensation of bugs crawling under one’s skin
Also seen in cocaine abusers (cocaine crawlies)
