class 8 (cognition)

Question 1

intact cognition

Answer 1

behaviour within normal range for age & culture

Question 2

impaired cognition

Answer 2

disturbance in 1 or + cognitive processes

Question 3

dementia and mental illness

Answer 3

is not a mental illness
proper DX is vital
appropriate & timely teratment
confusion & erratic behaviour

Question 4

dementia being treated/medicated as a mental illness

Answer 4

does not necessarily work & can make symptoms worse
-react to medications different d/t age
-dx is difficult with overlapping symptoms

Question 5

dementia & symptoms of depression

Answer 5

limited evidence for antidepressant to be effective
non-pharmacological interventions are prefered
reccomendation: pt with mild/ short duration depressive symptoms should be tx with psychosocial supportive interventions first

Question 6

what is dementia

Answer 6

progressive deterioration in intellectual functioning, memory, problem solving skills, acquisition of new skills
decline in ADL involvement, emotional changes, hallucination & delusions
-develops gradually with ongoing decline
80-90% of cases are irreversible

Question 7

primary source dementia

Answer 7

not reversible, progressive, not secondary to any other disorder i.e. alzheimer’s

Question 8

what is pseudodementia

Answer 8

exhibiting s&s of dementia but cause is depression

Question 9

secondary source dementia

Answer 9

occurs as a result of some other pathology i.e. AIDs relate dementia

Question 10

can persons living with dementia have good mental health?

Answer 10

yes
mental illness=/=mental health
can have good and bad days
its possible to improve & tx people w dementia

Question 11

how can we reduce stigma with dementia

Answer 11

may social isolate if feeling stigmatized=impacts mental health
advocate & educate to reduce stigma

Question 12

Canada’s national dementia strategy

Answer 12

sets out a vision for the future and identifies common principles and national objectives to help guide actions by all levels of government, non-governmental organizations, communities, families, and individuals
grounded in evidence-based practice

Question 13

alzhiemer’s disease

Answer 13

-form of dementia
-more common in females
-prevelance increasing with aging population
-full work up w physicla exam, FHx, environment, MSE,MMSE
-short, slow, clear, concise phrases, one at a time
-impacts: cognitive & functional abilities, emotions and moods, behaviours, physical abilities
-irreversible & NOT a part of aging

Question 14

non-pharmacological interventions for dementia

Answer 14

CBT
DBT
safe environment
decrease stimuli,
awareness of social challenges

Question 15

6 classes of med given for alzheimer’s disease

Answer 15

1. cholinesterase inhibitors
2. N-methyl-d-asparate (NMDA) anatgonist
   3.antidepressants
   4.antianxiety agents
   5.antipsychotics
   6.anticonvulsants

Question 16

cholinesterase inhibitors for tx of alzheimer’s disease

Answer 16

donepezil (Aricept) (early middle and late. daily= increase tolerance)
Rivastigmine (Exelon) (early, middle. oral/trandermal patch to dec GI upset)
Galantamine hydrobriomide (Reminyl ER)
-block the breakdown of acetylcholine
side effects: GI upset, insomnia, muscle cramps, incontinence, bradycardia, syncope

Question 17

NMDA antagonist for tx of alzheimer’s disease

Answer 17

memantine (Namenda)
reabsorption of glutamate
1st approved for mid-late stages
side effects: dizziness, agitation, headache, constipation, confusion

Question 18

antidepressants for alzheimer’s disease

Answer 18

SSRI’s (citalopram, fluoxetine)

Question 19

antianxiety agents for tx of alzheimer’s disease

Answer 19

lorazepam
oxasepam

Question 20

antipsychotics for tx of alzheimer’s disease

Answer 20

olanzapine
risperidone

Question 21

anticonvulsants for tx of alzheimer’s disease

Answer 21

carbamazepine

Question 22

assessment & treatment for delirium in older adults

Answer 22

altered LOC/confusion->MSE
polypharmacy
psychosis
changes in supports/environment i.e. ICU
physical needs: self care, safety, nutrition
behaviour: unpredictable, odd, bizarre behaviour
tx immediately, very good assessment to catch early
check for UTI, no glasses/hearing aids

Question 23

what is delirium?

Answer 23

medical emergency
more common among older persons
very common with adults who are in hospital
can be frightening
often not recognized or is misdiagnosed as another condition

Question 24

confusion assessment method (CAM)

Answer 24

4 features: must have 1,2 & EITHER 3 OR 4
1. acute mental status changes
2.inattention (squeeze my hand when u hear a letter)
3.disorganized thinking (can correctly answer yes or no q’s)
4.level of consciousness

Question 25

Canadian indigenous cognitive assessment (CICA)

Answer 25

uses two-eyed seeing to adapt cognitive screening tests for indigenous people

Question 26

what is the issue with the mental health comission of canada

Answer 26

limited accessability age limits to qualify of MH services

Question 27

what are we doing with the mental health commission of canada

Answer 27

lead insentives & projects decrease stigma promote guidelines for services increase capacity building

Question 28

mental health concerns in individuals with down syndrome

Answer 28

increase risk for alzheimers generalized anxiety adhd (inc s&s in kids; irritability, repetativeness, anxiety) asd depression neuropsychological problems sleep related issues ocd behaviours: oppositional, impulsive, inattentive

Question 29

depression in down syndrome kids & adults

Answer 29

environmental triggers can have a greater impact d/t sensitivity to change in environment

Question 30

primary disabilities in fetal alcohol spectrum disorder

Answer 30

those most directly related to CNS damage cause by prenatal exposure to alcohol examples: inconsistent memory & recall, inability to filter out environment or emotional stimuli, impulsivity & poor judgement

Question 31

secondary disabilities in fetal alcohol spectrum disorder

Answer 31

not present at birth, occur later in life as a result of the primary disabilities examples: mental health problems, substance misuse, disrupted school experience, poor academic achievement

Question 32

pharamcological interventions for fetal alcohol spectrum disorders

Answer 32

stimulants; methylphenidate (ritalin) *inc activity antidepressants; atomoxetine (strattera) *depression antipsychotics; risperidone (risperdal) *aggression + behaviour anxiolytics; clonidine (catapress) *sleep

Question 33

nonpharmacological interventions for fetal alcohol spectrum disorders

Answer 33

interdisciplinary team involvement; SLP, OT, PT, mental health care behavioural therapy alternative approaches; meditation, art therapy etc

Question 34

what is a dual diagnosis?

Answer 34

a diagnosis of both an intellectual disability and mental health problems causes; issues with expressing thoughts & feelings, difficulty self reporting

Question 35

learning disabilities impact on mental health

Answer 35

anxiety and depression social isolation low self-esteem substance misuse -affects organization, attention, retention