Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Y3 PSYCHIATRY > Delirium and Memory Problems > Flashcards

Delirium and Memory Problems Flashcards

1
Q

What is the most common mental health problem in hospitalised patients above the age of 65?

A

Delirium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the main features of delirium?

A 
Impaired consciousness
Disturbed cognition
Psychomotor disturbance
Emotional disturbance
Disturbed sleep-wake cycle
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What might be seen clinically if a patient has impaired consciousness?

A

Clouding
Drowsiness
Stupor
Coma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What might be seen clinically if a patient has disturbed cognition?

A

Disorientated for time and place
Impaired memory and attention
Impaired thinking
Perceptual disturbance (hallucinations, delusions)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the 2 main psychomotor variants of delirium?

A

Hypoactive
Hyperactive
Can get mixed picture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What might be seen clinically if a patient has hypoactive delirium?

A

Confusion
Sedation
Depression (misdiagnosis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What might be seen clinically if a patient has hyperactive delirium?

A

Agitation
Aggression
Hallucinations, delusions
Disorientation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Describe the course of delirium

A

Fluctuating, transient course
Rapid onset
Can last days to months depending on cause

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What drugs can typically cause delirium?

A 
Anticholinergic
Anticonvulsant
Parkinson drugs
Steroids
Opiates
Alcohol
Illicit drugs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Withdrawal from what substances can typically cause delirium?

A

Alcohol
Benzodiazepines
Barbiturates
Illicit drugs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

List some metabolic abnormalities that can typically cause delirium

A

Hypoxia
Hypoglycaemia
Hypo/hyperthyroidism
Hypopituitarism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

No identifiable cause excludes a diagnosis of delirium. True/False?

A

False

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

List the main risk factors for delirium

A 
Elderly
Existing dementia
Sensory deficits
Perioperative
Previous episode
Immobility
Social isolation, stress
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Sedating drugs can worsen delirium. True/False?

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How is delirium due to alcohol withdrawal managed with medication?

A

Benzodiazepine (chloridazepoxide, diazepam)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the general management of delirium?

A

1ST LINE = environmental measures (reality oreintation, sensory impairment, light, noise, basic needs)
Antipsychotic - haloperidol
Lorazepam in PD, LWB dementia, neuroepileptic sensitivity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Who typically gets hyperactive delirium?

A

Elderly with recent injury e.g. hip fracture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What time of day is delirium typically worse?

A

Night

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is the shortest type of memory?

A 
Sensory memory (less than 1 sec)
Short-term (less than 1 minute)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

List the 2 main domains of long-term memory and their function

A 
Explicit memory (conscious)
Implicit memory (unconscious)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Procedural memory is part of what - implicit or explicit memory? What kind of memory does it enable?

A

Implicit memory

Remembering skills and doing tasks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Declarative memory is part of what - implicit or explicit memory? What kind of memory does it enable?

A

Explicit memory

Remembering facts and events

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What are the 2 main domains of declarative memory and their memory functions?

A 
Episodic memory (events, experiences)
Semantic memory (facts, concepts)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is anterograde amnesia?

A

Difficulty acquiring new material and remembering events since onset of illness/injury

25
Q

What is retrograde amnesia?

A

Difficulty remembering information prior to onset of illness/injury

26
Q

List some typical reports of memory problems

A 
Forgetting a message
Losing track of conversation
Forgetting to do things
Inability to navigate to familiar places
Misplacing things
Struggling with names
27
Q

What are the main domains assessed in cognitive screening?

A 
Memory
Attention, concentration
Executive function
Visuo-spatial function
Language
28
Q

List diagnostic investigations used in delirium

A 
Formal cognitive testing
Urine analysis
FBC, U+Es, LFTs
Thyroid function
Blood glucose
CRP
B12 + folate
CXR/ CT brain
EEG (diffuse background slow wave activity)
29
Q

Which two illnesses have a strong association with development of depression?

A

Stroke

MI

30
Q

List precipitating causes of delirium

A

PINCH ME
PAIN
ILLNESS: urinary retention
INFECTION: UTI, lungs, stomach
NEUROLOGICAL: withdrawal, alcohol
CONSTIPATION CATHETER CARDIOEMBOLIC HYDRATION HYPO: thyroid, natraemia, kalaemaia, thermia, glycaemia, xia
MEDICATION: new meds/ change in meds ENVIRONMENTAL: hospital, surgery

31
Q

List the criteria for diagnosing dementia

A 
2 or more of:
Forgetfulness
Memory loss
Confusion
Poor reasoning and logic
Personality change
Poor judgement
Ability to focus
Visual perception
32
Q

Compare the memory impairment in dementia, delirium and depression

A

DEMENTIA: Recent and remote impairment
DELIRIUM: Recent impairment
DEPRESSION: Remote intact, concentration poor

33
Q

List cognitive tests used to diagnose dementia

A 
4AT (rapid screening for delirium)
MMSE
Bedside tests (GPCOG, 6CIT)
MoCA (rapid screening for mild cognitive dysfunction)
ACER (between MMSE and neurophysiology)
Frontal assessment battery
Neurophysiology
34
Q

What is the cute off for diagnosis of dementia using the MMSE?

A

<24/30

35
Q

Clock drawing tests the function of which lobes of the brain?

A

Fronto-parietal lobes

36
Q

What is the purpose of neurophysiological assessment?

A

Whether intellectual/ behavioural decline is linked to disease of CNS

37
Q

Define ‘dementia’

A

Syndrome due to disease of brain, which is irreversible and progressive, with global cognitive decline over months-years, and reduced emotional control, social ability and motivation

38
Q

List non-pharmacological management options for dementia

A 
Environmental measures (sleep, exercise, medications, carer education)
Post diagnostic counselling
Advance planning
Practical and legal advice inc. driving
OT assessment
39
Q

What is ‘mild cognitive impairment’?

A

Minor problems with cognition - their mental abilities such as memory or thinking - that are worse than expected for a healthy person of their age.
Increased risk of developing dementia

40
Q

Alzheimer’s disease typically follows what pattern of memory loss? Which lobe of the brain is affected first?

A

Short-term memory loss first

Medial temporal lobe

41
Q

Vascular dementia follows what pattern of decline?

A

Step-wise decline in cognition

42
Q

List the three main variants of fronto-temporal dementia

A

Behavioural variant
Primary progressive aphasia
Semantic dementia

43
Q

List red flags for dementia presentation

A 
Fast progression
Young patient
Neurological sings
FHx of rare/ young dementia
Clues in PMHx e.g. HIV
44
Q

A SPECT scan is most useful for diagnosing which type of dementia?

A

Fronto-temporal dementia

45
Q

A DaT scan is most useful for diagnosing which type of dementia? What is the classical appearance?

A

Lewy body or Parkinson’s dementia

Full stop sign

46
Q

An MRI scan is most useful for diagnosing which type of dementia?

A

Younger patients, fast progression, atypical presentation

47
Q

How does Alzheimer’s disease present on imaging?

A

Cortical atrophy
Dilated ventricles
Widened sulci
Narrowed gyrus

48
Q

Where do small vessel changes typically occur in the brain in vascular dementia?

A

Periventricular white matter

49
Q

What is the mechanism of action of anti-cholinesterase inhibitors?

A

Block cholinesterase and increase ACh in synapse

50
Q

Which anti-cholinesterase inhibitors are first line in Alzheimer’s disease?

A

Donepezil
Rivastigmine
Galantamine

51
Q

Which anti-cholinesterase inhibitors are first line in DLB and PD? What symptom do they help control?

A

Rivastigmine
Donepezil
Visual hallucinations

52
Q

List side effects of anti-cholinesterase inhibitors

A

GI (nausea, diarrhoea)
Headache
Muscle cramps
Bradycardia

53
Q

Anti-cholinesterase inhibitors are contraindicated in…

A

Active peptic ulcers
Severe asthma
Severe COPD

54
Q

Which medication should be used in Alzheimer’s disease when anti-cholinesterase inhibitors are contraindicated? What do they help prevent?

A

Memantine

BPSD (Behavioral and psychological symptoms of dementia)

55
Q

List side effects of memantine

A 
Hypertension
Sedation
Dizziness
Headache
Constipation
56
Q

What other class of drug can be considered for prescribing in dementia?

A

Antidepressants

57
Q

Behavioural difficulties in fronto-temporal dementia can be controlled with which medication?

A

Trazadone

58
Q

Antipsychotics are contraindicated in which type of dementia?

A

Lewy body dementia

59
Q

List aetiology of dementia

A

GENETIC: Huntingdons’s, wilson’s, porphyria
INFECTIOUS: Syphillus, prions, encephalitis
CVD
METABOLIC: Hypothyroidism, thiamine (alcohol)
CEREBRAL TUMOURS
DEGENERATIVE: Alzheimer’s, parkinson’s
DEMYELINATION
TRAUMA: Major head injury
NORMAL PRESSURE HYDROCEPHALUS

Y3 PSYCHIATRY (23 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions