DELIRIUM AND OTHER CONFUSIONAL STATES

Question 1

__________ is a general term denoting the patient’s incapacity
to think with customanJ speed, clarity, and coherence.

Answer 1

Confusion

Question 2

Confusion is also a characteristic feature of the
chronic syndrome of ___________, where it is the product of a progressive failure of cognition, language, memory, and other intellectual functions

Answer 2

dementia

Question 3

_______________ is characterized by a prominent disorder
of perception; hallucinations and vivid dreams; a kaleidoscopic
array of strange and absurd fantasies and delusions;
inability to sleep; a tendency to twitch, tremble,
and convulse; and intense fear or other emotional reactions.

Answer 3

delirium

Question 4

Delirium is distinguished not only by extreme inattentiveness but also by a state of heightened ____________

Answer 4

alertness

Question 5

The failure in the amnesic state is one of ____________ and must be distinguished from states of drowsiness, acute confusion, and delirium, in which information and
events seem never to have been adequately perceived
and registered in the first place.

Answer 5

retention, recall, and reproduction

Question 6

the term dementia (literally, an undoing of the mind) denotes a deterioration of all intellectual
or cognitive functions with little or no disturbance of ___________

Answer 6

consciousness or perception

Question 7

Memory may be arbitrarily
subdivided into several parts: 
1
2
3
4

Answer 7

( 1 ) registration;
(2) fixation, mnemonic integration, and retention; 
(3) recognition
and recall; and 
(4) reproduction

Question 8

In the _____________, newly presented
material appears to be correctly registered but cannot be
retained for more than a few minutes (an terograde amnesia, or failure of learning

Answer 8

Korsakoff amnesic syndrome,

Question 9

defect in the recall and reproduction of
memories that had been formed several days, weeks,
or even years before the onset of the illness

Answer 9

retrograde amnesia

Question 10

Intact retention with failure
of recall (retrograde amnesia without anterograde
amnesia) when it is severe and extends to all events of
past life and even personal identity, is usually a manifestation of ________________

Answer 10

hysteria or malingering

Question 11

___________ the highest order o f intellectual activity,

remains the most elusive of all mental operations

Answer 11

Thinking,

Question 12

Disorders of thinking are quite prominent in delirium

and other confusional states, in ______, ________ and __________

Answer 12

mania, dementia, and schizophrenia

Question 13

This overall reduction in thought and action is
the most prominent feature of diseases that damage the
_____________

Answer 13

frontal lobes

Question 14

A related condition of slowed thought, or ______________is comparable to the bradykinesia of extrapyramidal
disorders

Answer 14

bradyphrenia,

Question 15

When a false belief is
maintained in spite of convincing evidence to the contrary,
the patient is said to have a _______

Answer 15

delusion

Question 16

Also diagnostic of some forms of __________are distortions of logical thought, such as gaps in sequential thinking, intrusion of irrelevant ideas, and condensation of associations

Answer 16

schizophrenia

Question 17

Affective displays that are excessively labile and poorly
controlled or uninhibited are a common manifestation
of many cerebral diseases, particularly those involving
the _______ and ________

Answer 17

corticopontine and corticobulbar pathways.

Question 18

Affect being the external appearance of
emotional life, the __________is characterized by
a relative disconnection between the patient’s reported
emotional feelings and the outward display, most often
being in the same general direction

Answer 18

pseudobulbar state

Question 19

it is convenient to divide emotionality

into ______ and_______

Answer 19

mood and affect

Question 20

By ________ is meant the prevailing
internal emotional state of an individual.

By contrast, ____________ (or feeling) refers to the outward emotional reactions evoked by a thought or an environmental stimulus.

Answer 20

mood

affect

Question 21

Disorders of these parts of
the motor system interfere with voluntary or automatic
movements, much to the distress of the patient

Answer 21

Distu rba n ces of I m p u lse (Conati o n )

a n d Activity

Question 22

With certain cerebral
diseases the disinclination to move and act may reach
an extreme degree, to a point where a person who is
wide awake and perceptive of the environment does not
speak or move for weeks on end. What is this condition?

Answer 22

akinetic mutism

Question 23

Profound depression or other psychosis

is the usual cause of _____

Answer 23

catatonia

Question 24

completely inert catatonic patient develops a high fever,

collapses, and dies

Answer 24

lethal catatonia

Question 25

In
abulia, catatonia, and depression, the mind is usually
sufficiently alert to record events and later to recount
them, which differentiates these states from _______

Answer 25

stupor

Question 26

Akathisia refers to constant restless movements and
inability to sit still; in some patients, this is a consequence
of the prolonged use of ______

Answer 26

phenothiazines, butyrophenones,

newer anti psychosis drugs, and L-dopa,

Question 27

In the __________
(and to a lesser extent in hypomania), continuous activity
and insomnia are added to the flight of ideas and the
euphoric (although somewhat irritable) mood

Answer 27

manic form of bipolar disease

Question 28

From the neurologic perspective, the generic term
________applies to states of confusion in which elements
of hallucinations, delusions, and disordered thinking
comprise the prominent features

Answer 28

psychosis

Question 29

Characteristically, these abnormalities fluctuate in

severitt;, typically being worse at night_______

Answer 29

(“sundowning” ) .

Question 30

This i s best depicted in the patient undergoing withdrawal from alcohol after a sustamed period of intoxication.
The symptoms usually develop over a period of
2 or 3 d.

The first indications are difficulty in concentration,
restless irritability; increasing tremulousness, and
insomnia.

Answer 30

Deliri u m

Question 31

lesions associated with delirium

Answer 31

they tend to be localized in the rostral midbrain and hypothalamus or in the temporal lobes, where they involve the reticular activating and limbic
systems.

Question 32

what kind of hallucination is this?

Subthalamic and midbrain lesions may give rise to visual hallucinations that are not unpleasant and are accompanied by good insight

Answer 32

(“peduncular hallucinosis” of Lhermitte

Question 33

By contrast, in the toxic ________
associated with excessive doses of the newer antidepressant
drugs, salivation is normal, sweating is increased, and
the gut is hyperactive; diarrhea is common

Answer 33

serotonergic syndrome

Question 34

Allied compounds
with sympathomimetic actions such as ______ and __________ produce a hallucinatory delirium and
yet others with different pharmacologic properties such as
glutaminergic activity may result in a variety of delirious
fragments or pure hallucinosis

Answer 34

cocaine

and phencyclidine

Question 35

With regard to medications, those with __________have the highest tendency to cause confusion, but
others, even seemingly innocuous ones, may do the same

Answer 35

atropinic

effects

Question 36

global confusional

state occurs in patients with severe burns (_________

Answer 36

burn

encephalopathy).