Delirium/Dementia Flashcards Preview

Term IV: Behavioral Science > Delirium/Dementia > Flashcards

Flashcards in Delirium/Dementia Deck (28):
1

Delirium is associated with:

A. Decreased mortality
B. A gradual onset
C. Alteration in level of consciousness/attention
D. Rapid improvement in underlying medical condition

C

2

Delirium is a disturbance in ____ and _____

Attention and awareness

3

T or F: Delirium develops over a long period of time.

FALSE - short period of time and fluctuates

4

3 delirium subtypes:

Hypoactive
Hyperactive
Mixed

5

Neuropathogenesis of delirium (list 3)

- Impairment of cholinergic system
- Excess dopamine
- Increased GABA activity

6

Which of the following is NOT associated with an increased likelihood of delirium?

A. Infections
B. Alcohol withdrawal
C. PTSD
D. Stroke

C

7

Critical and emergent causes of delirium

Infection, withdrawal, acute metabolic, hypoxia, trauma, endocrinopathies, deficiencies, acute vascular accident, toxins/drugs/heavy metals

8

Can delirium lead to death?

YES

9

Predisposing factors for delirium

Older age, depression, stroke or TBI, alcohol abuse, male sex, dehydration, dementia

10

Precipitating factors for delirium

Anticholinergic meds ,UTI hyponatremia, hypoxemia, bladder catheter, ortho/cardiac surgery, narcotics, ICU admission, physical restraint

11

What labs should you run to determine underlying cause of delirium?

Electrolytes, BUN/Cr, LFTs, CBC, thyroid, urinalysis and toxicology, medication blood levels, EKG, CXR, CT

12

What medications can you prescribe for delirium?

Haloperidol, atypical antipsychotics (Risperidone, Olanzapine, Quetiapine), Lorazepam for alcohol detox

13

What behavioral treatments can you use to treat delirium?

AVOID RESTRAINTS, orienting devices (clocks, calendars, family pics), well-lit room, calm quiet env, frequent re-orientation

14

Dementia is cognitive decline in one or more cognitive domains that interferes w/ everyday activities:

(name the domains)

1. Complex attention - sustained attn, processing speed
2. Executive function - planning, decision making, error correction
3. Learning & Memory
4. Language
5. Perceptual-motor - visual perception, praxis, gnosis
6. Social cognition - recognition of emotions, theory of mind

15

Three most common dementia subtypes:

#1 - Alzheimer's
Tied for #2 - Lewy Body, Vascular

Others: prion disease, alcohol abuse, TBI

16

Neuropathology of Alzheimer's

Plaques (collections of AB protein)

Tangles (hyperphosphorylated tau protein)

17

Neuropathology of Lewy Body dementia

Lewy bodies

18

Neuropathology of vascular dementia

Chronic microvascular disease, large vascular events

19

- Donepezil (Aricept)
- Galantamine (Razadyne)
- Rivastigmine (Exelon)

Acetylcholinesterase inhibitors

Treat dementia

20

Memantine (Namenda)

NMDA antagonist

Treats dementia

21

What additional neuropsychiatric symptom can be seen with Alzheimer's dementia?

Delusions, depression, anxiety, hallucinations

22

What brain lobe can contribute to behavioral disturbances in dementia patients?

Frontal lobe

23

Which of the following meds has a black box warning regarding increased mortality in the elderly?

A. Antipsychotics
B. Antidepressants
C. Anticonvulsants
D. Cholinesterase inhibitors

A

24

Pharmacological treatment for behavioral symptoms of dementia

Acetaminophen
Acetylcholinesterase inhibitors
Trazodone, SSRI

Anticonvulsants and antipsychotics avoided

25

Delirium or dementia?

Acute/subacute

Delirium

(Dementia has insidious onset)

26

Delirium or dementia?

Chronic, progressive

Dementia

(Delirium is transient, reversible)

27

Delirium or dementia?

Non-fluctuating

Dementia

(Delirium is fluctuating)

28

Delirium or dementia?

Disorientation

Delirium

(Dementia - sensorium usually clear)