Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

ADPY 7500 > 8. Neurocognitive disorders > Flashcards

8. Neurocognitive disorders Flashcards

(52 cards)

Start Studying
1
Q

ICU Triad

A

Delirium
Pain
Agitation

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

Timing of delirium symptoms

A

Fluctuate throughout the day

Worse at night

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

Medications that induce delirium

A 
TCAs
Anticholinergics
Benzodiazepines
Nonbenzo hypnotics "Z-drugs"
Corticosteroids
H2 blockers
Meperidine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Most common causes of delirium in kids

A

Fever

Meds

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

Manifestation of delirium on EEG?

A

Diffuse background slowing

*Exception: delirium tremens (fast activity)

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

Likely diagnosis: Delirium + hemiparesis or other focal neuro signs

A

cerebrovascular accident or mass lesion

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

Delirium + elevated BP + papilledema

A

Hypertensive encephalopathy

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

Delirium + Dilated pupils + tachycardia

A

Drug intoxication

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

Delirium + fever + nuchal rigidity + photophobia

A

Meningitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Delirium + Tachycardia + tremor + thyromegaly

A

Thyrotoxicosis

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

Typical symptoms of delirium

A 
Short attention span
Disorientation
Fluctuations in level of consciousness
visual hallucinations
Impairment in recent memory
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Most common type of delirium?

A

Mixed: psychomotor activity remains stable at baseline or fluctuates rapidly between hyperactivity and hypoactivity

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

Type of delirium most likely to go undetected?

A

Hypoactive: decreased motor activity, drowsiness to lethargy to stupor. More common in elderly.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

ICU psychosis type of delirium

A

Hyperactive: agitation, mood lability, uncooperative.

More common in drug withdrawal or toxicity

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

Tool for evaluation of a patient with suspected delirium. High sensitivity and specificity

A

Confusion Assessment Method (CAM)

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

Once delirium has been diagnosed, the cause should be sought by obtaining what tests/procedures?

A

Finger-stick blood glucose
Pulse-oximetry
Arterial blood gases
ECG

Labs: BMP
CBC with diff
Urinalysis
Urine culture

Urine drug screen
Blood alcohol level
Therapeutic drug levels (Ex. Lithium, digoxin, antiepileptics)
Hepatic panel
Thyroid hormone levels
CXR depending on presentation

Head imaging: CT or MRI
EEG
LP
*If focal neurological defecits present or cause of delirium cannot be identified with initial workup

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

Preferred agent for treatment of agitation

A

Haloperidol (D2 antagonist)

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

Avoid using benzos to treat delirium unless it is due to?

A

Alcohol or benzo withdrawl

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

Causes of neurocognitive disorders that present like dementia but progression may be halted/reversed with treatment

A

Vit B12 def.
Thyroid dysfunction
Normal pressure hydrocephalus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Likely diagnosis for: cognitive impairment with stepwise increase in severity + focal neurological signs

A

Vascular disease

*Get head CT or brain MRI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Cognitive impairment + cogwheel rigidity + resting tremor

Study These Flashcards
A

Lewy body disease
Parkinson’s disease

*Clinical dx

22
Q

Cognitive impairment + gait apraxia + urinary incontinence + dilated cerebral ventricles

Study These Flashcards
A

Normal pressure hydrocephalus

*Get head CT or brain MRI

23
Q

Cognitive impairment + fatigue + cold intolerance + coarse hair + constipation

Study These Flashcards
A

Hypothyroidism

*Get TSH, free T4

24
Q

Cognitive impairment + parasthesias + diminished position and vibration sensation + megaloblasts on CBC

Study These Flashcards
A

Vitamin B12 deficiency

*Get serum B12

25
Cognitive impairment + tremor + Fleischer rings + abnormal LFTs
Wilson's Disease *Get ceruloplasmin level
26
Cognitive impairment + diminished position and vibration sensation + Argyll Robertson Pupils (accomodation response present, response to light absent)
Neurosyphillis Get CSF FTA-ABS and VDRL
27
How may hYPERthyroidism present in the elderly?
"Apathetic thyrotoxicosis" Depression and lethargy
28
5 categories of the MMSE Total points?
``` Orientation Registration Attention Recall Language ``` 30 points
29
Most common etiology of major neurocognitive disorder?
Alzheimer's disease
30
Primary cognitive domains affected in Alzheimers?
Memory Learning Language
31
Found in brain of Alzheimer's disease?
Senile plaques and neurofibrillary tangles
32
Only way to definitively diagnose Alzheimer's disease
Postmortem path exam
33
Accumulation of what (where?) is associated with progressive brain atrophy in Alzheimer's disease?
Extraneuronal Beta-amyloid plaques | Intraneuronal tau protein tangles
34
What protein mutations cause autosomal dominant Alzheimer's diseae? This makes up 1 % of AD
Single gene mutations in either: Amyloid precursor protein Presenilin 1 Presenilin 2
35
Risk factor for early onset Alzheimer's disease?
Having the Epsilon-4 variant of the apolipoprotein gene
36
Fraction of patients diagnosed with AD that are women?
2/3
37
Class of drugs that is associated with increased mortality in patients with dementia
Antipsychotics
38
2nd most common cause of major NCD?
Vascular dementia
39
Cognitive domains typically affected in vascular dementia small vessel disease?
*These are lacunar infarcts Complex attention and executive functions
40
Antipsychotics that can be used for psychotic symptoms in Lewy Body Dementia
Quetiapine or Clozapine
41
Treatment of REM sleep disorder in Lewy body dementia
Melatonin or clonazepam
42
Core features of Lewy body dementia
Waxing and waning cognition Visual hallucinations Extrapyramidal signs (Parkinonism)
43
Suggestive features of lewy body dementia
REM sleep behavior disorder: violent movements during sleep | Pronounced antipsychotic sensitivity
44
Clinical manifestation of frontotemporal dementia
defecits in attention, abstraction, planning, problem solving Behavioral variant: disinhibited verbal, pysical, or sexual behavior, lack of emotional warmth, overeating, apathy, perseveration, decline in social cognition Language variant: Difficulties with speech and comprehension
45
Treatment of frontotemporal dementia?
Serotonergic meds may help reduce disinhibition, anxiety, impulsivity, etc.
46
Most common infectious agent known to cause cognitive impairment
HIV *HAART improves cognition in some patients
47
Inheritance of Huntington Disease
Autosomal dominant
48
Primary cognitive domain affected in Huntington Disease
Executive function
49
Patient's often aware of deteriorating mentation
Hungtington Disease
50
Symptom tx of Huntington Disease
Tetrabenazine | or atypical antipsychotics
51
Rapidly progressive cognitive decline + myoclonus
Creutzfeldt Jakob Disease
52
3 W's of Normal pressure hydrocephalus
Wet=urinary incontinence Wobbly= gait disturbance Wacky=cognitive impairment

ADPY 7500 (17 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions