504-505 Cognitive d/o, delirium, dementia, psychosis, schizo, delusional Flashcards Preview

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Flashcards in 504-505 Cognitive d/o, delirium, dementia, psychosis, schizo, delusional Deck (39)
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1

What are the components of cognition?

memory, attention, language, and judgment

2

What are the effects of delirium on:
1. consciousness
2. attention span
3. level of arousal
4. thinking
5. sleep
6. cognition

1. "waxing and wanning" level of consciousness with acute onset
2. rapid ↓ in attention span
3. rapid ↓ in level of arousal
4. disorganized thoughts, hallucinations, illusions, misperceptions
5. disturbance in sleep-wake cycle
6. cognitive dysfunction

3

What are the causes of delirium?

Usually secondary to other illness:
- CNS diseases, infection, trauma, substance abuse/withdrawal, metabolic/electrolyte disturbances, hemorrhage, urinary/fecal retention

4

What is dementia?

Gradual ↓ in intellectual ability or "cognition" w/out affecting level of consciousness

5

What are the symptoms of dementia?

memory deficits, aphasia, agnosia, loss of abstract thought, behavioral/personality changes, impaired judgement

6

What are irreversible causes of dementia?

Alzheimer disease, Lewy body dementia, Huntington disease, Pick disease, cerebral infarcts, CJD, chronic substance abuse (→ neurotoxicity)

7

Reversible causes of dementia:

NPH, vitamin B12 deficiency, hypothyroidism, neurosyphilis, HIV (partially)

8

dementia epidemiology:

incidence ↑ w/ age

9

EEG findings in dementia:

abnormal

10

In elderly patients, what can mimic dementia? What is this called?

depression; psuedodementia

11

What is psychosis?

a distorted perception of reality characterized by delusions, hallucinations, and/or disorganized thinking

12

What kinds of patients are affected by psychosis?

patients with medical illness, psychiatric illness, or both

13

Hallucinations are:

perceptions in the absence of external stimuli (e.g. seeing a light that is not actually present)

14

Delusions are:

unique, false beliefs about oneself or others that persist despite the facts (e.g. thinking aliens are communicating with you)

15

What is disorganized speech?

Words and ideas ares strung together based on sounds, puns, or "loose associations"

16

What are the types of hallucination?

Visual, auditory, olfactory, gustatory, tactile, hypnagogic, and hypnopompic

17

What type of hallucination is more commonly associated with medical illness than psychiatric illness?

Visual hallucinations

18

What type of hallucination is more commonly associated with psychiatric illness than medical illness?

Auditory hallucinations

19

When do olfactory hallucinations usually occur?

as an aura of psychomotor epilepsy and in brain tumors

20

When do tactile hallucinations commonly present?

alcohol withdrawal (e.g. formication - sense of bugs crawling on one's skin) and cocaine abusers ("cocaine crawlies")

21

When do you see hypnagogic hallucinations?

When you GO to sleep

22

When do you see hypnapompic hallucinations?

When you wake up

23

What is schizophrenia?

A chronic mental disorder with periods of psychosis, disturbed behavior and thought, and decline in functioning that lasts > 6 months.

24

What abnormal level of what neurotransmitter activity is found in schizophrenia?

↑ dopaminergic activity

25

What is the effect of schizophrenia on neurons?

↓ dendritic branching

26

What are the positive symptoms of schizophrenia?

1. Delusions
2. Hallucinations - often auditory
3. Disorganized speech (loose associations)
4. Disorganized or catatonic behavior

27

What are the negative symptoms of schizophrenia?

1. flat affect
2. social withdrawal
3. lack of motivation
4. lack of speech or thought

28

What is the etiology of schizophrenia

genetics and environment contribute

29

Lifetime prevalence and groups affected by schizophrenia:

1.5% (♂ = ♀ ; black = white)

30

When does schizophrenia present in males?

late teens - early 20s