Delirium/Dementia Flashcards
Delirium is associated with:
A. Decreased mortality
B. A gradual onset
C. Alteration in level of consciousness/attention
D. Rapid improvement in underlying medical condition
C
Delirium is a disturbance in ____ and _____
Attention and awareness
T or F: Delirium develops over a long period of time.
FALSE - short period of time and fluctuates
3 delirium subtypes:
Hypoactive
Hyperactive
Mixed
Neuropathogenesis of delirium (list 3)
- Impairment of cholinergic system
- Excess dopamine
- Increased GABA activity
Which of the following is NOT associated with an increased likelihood of delirium?
A. Infections
B. Alcohol withdrawal
C. PTSD
D. Stroke
C
Critical and emergent causes of delirium
Infection, withdrawal, acute metabolic, hypoxia, trauma, endocrinopathies, deficiencies, acute vascular accident, toxins/drugs/heavy metals
Can delirium lead to death?
YES
Predisposing factors for delirium
Older age, depression, stroke or TBI, alcohol abuse, male sex, dehydration, dementia
Precipitating factors for delirium
Anticholinergic meds ,UTI hyponatremia, hypoxemia, bladder catheter, ortho/cardiac surgery, narcotics, ICU admission, physical restraint
What labs should you run to determine underlying cause of delirium?
Electrolytes, BUN/Cr, LFTs, CBC, thyroid, urinalysis and toxicology, medication blood levels, EKG, CXR, CT
What medications can you prescribe for delirium?
Haloperidol, atypical antipsychotics (Risperidone, Olanzapine, Quetiapine), Lorazepam for alcohol detox
What behavioral treatments can you use to treat delirium?
AVOID RESTRAINTS, orienting devices (clocks, calendars, family pics), well-lit room, calm quiet env, frequent re-orientation
Dementia is cognitive decline in one or more cognitive domains that interferes w/ everyday activities:
(name the domains)
- Complex attention - sustained attn, processing speed
- Executive function - planning, decision making, error correction
- Learning & Memory
- Language
- Perceptual-motor - visual perception, praxis, gnosis
- Social cognition - recognition of emotions, theory of mind
Three most common dementia subtypes:
#1 - Alzheimer's Tied for #2 - Lewy Body, Vascular
Others: prion disease, alcohol abuse, TBI
