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Psychiatry > Dementia + Delirium > Flashcards

Dementia + Delirium Flashcards

(56 cards)

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1
Q

What are the different types of dementia

A

Alzheimer’s
Vascular dementia
Lewy Body
Fronto-temporal

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2
Q

Which is the most common type of dementia

A

Alzheimer’s

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3
Q

Describe Alzheimer’s

A

Chronic neurodegenerative disease with insidious and progressive but slow decline

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4
Q

What is the MAJOR risk factor for Alzheimer’s

A

Age

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5
Q

Is Alzheimer’s reversible

A

No

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6
Q

Is Alzheimer’s progressive

A

Yes

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7
Q

Clinical features of Alzheimer’s

A 
Memory loss 
Disorientation 
Nominal dysphasia 
Misplacing items 
Getting lost 
Apathy 
Decline in activities 
Personality change
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8
Q

O/E findings in Alzheimer’s

A

Unremarkable

None to note

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9
Q

Ix for Alzheimer’s

A

MOCA
MSSE

Collateral history

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10
Q

Reversible causes of alzheimer’s

A 
Hypothyroidism 
Intracerebral bleed/tumour B12 deficiency 
Hypercalcaemia 
NPH (wet wobbly wacky)
Depression
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11
Q

What type of specificity does capacity have

A

Capacity is decision specific

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12
Q

What is a power of attorney

A

Someone whom the patient/person has appointment to make decisions should they lack capacity

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13
Q

Pharmacological Rx for Alzheimer’s

A

Cholinisterase inhibitors
NDMA Antagonist
Antidepressants
Anti-psychotics

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14
Q

Which Cholinisterase inhibitor is used to treat AD

A

Donepezil

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15
Q

Which NDMA antagonist is used to treat AD

A

Memantine

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16
Q

Risk factors for AD

A

Age
FH
Vascular risk factors

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17
Q

Which anti-psychotic can sometimes be prescribed in AD

A

Risperidone

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18
Q

non-pharmacological management of Alzheimer’s

A 
Support for person and carers 
Cognitive stimulation 
Exercise 
Environmental design 
Music/light therapy 
Reality orientation therapy 
Validation therapy §
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19
Q

What type of history is crucial for any form of dementia

A

Collateral

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20
Q

What progression does Vascular dementia typically show

A

Step wise

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21
Q

Risk factors for vascular dementia

A 
Hypertension 
Age
DM 
Smoking 
Hyperlipidaemia 
Obesity 
Alcohol 
AF 
IHD
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22
Q

Symptoms of vascular dementia

A 
Memory loss 
Difficulty concentrating 
difficulty finding words
Change in personality 
Confusion 
Disorientation
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23
Q

Can the same pharmacological methods used to treat Alzheimers be used in vascular dementia

24
Q

Management of vascular dementia

Study These Flashcards
A 
OT 
Physio
Support for person and carers 
Cognitive stimulation 
Exercise 
Environmental design 
Music/light therapy 
Reality orientation therapy 
Validation therapy
25
What is the mean survival of AD
7 yrs
26
Which disease does lewy body dementia have a strong link with
Parkinson's
27
Clinical features of Lewy body
``` Hallucinations common Falls Fluctuating confusion and alertness Parkinsonism REM sleep ```
28
Which type of sleep will Lewy body affect
REM
29
Features of Parkinsonism
Bradykinesia Tremor Postural instability y Rigidity
30
Ix for Lewy Body dementia
MOCa MMSE Collateral history Sometimes MRI brain
31
Pharmacological Rx Lewy Body Dementia
Acetylcholinisterase inhibitor e.g Dozezepril Memantine Antidepressant Anti-psychotic
32
What is the typical pictures of frontotemporal dementia
Early symptoms different from other dementias: Behavioural change Language difficulties Memory early on not often affected
33
Compare the onset of frontotemporal dementia
Often an early onset
34
Where does frontotemporal dementia affect
Fronto-temporal lobes
35
What is the first thing normally to change in front-temporal dementia
Behaviour
36
What is the pharmacological Rx of fronton-temporal dementia
No pharmacological Rx
37
Non-pharmacological Rx for frontotemporal dementia
``` Support for person and carers Physio. OT Cognitive stimulation Exercise Environmental design Music/light therapy Reality orientation therapy Validation therapy ```
38
Clinical features of fronts-temporal dementia
``` Early behavioural change Drastic personality change Early dysphagia Emotional unconcern Changes in eating habits Loss of personal hygiene ``` Memory often affected later on
39
Is delirium common or uncommon
Very common
40
What are the 3 types of delirium
Hyperactive Hypoactive Mixed
41
Potential causes of delirium
``` Infection (e.g UTI) Dehydration Pain Constipation Drugs Urinary retention Hypoxia Alcohol/drug withdrawal Brain injury SLE Endocrinopathies ```
42
Key clinical features of delirium
``` Disturbed consciousness Acute onset Fluctuant course Change in cognition: Memory Perceptual Language Illusions Hallucination (auditory/visual) ```
43
Which scores can be used to assess for delirium
4AT | AMT
44
Non-Pharmacological Rx for delirium
``` Reorientate and Reassure: Use families/carers Normalise sleep wake cycle Continuity f care Avoid urinary catheterisation ```
45
Rx for delirium
``` Non-pharmacological measures Remove any bad/precipitating drugs Enema/laxatives Abx. analgesia ```
46
Should you sedate patients who have delirium
Try to avoid
47
What is the commonest complication of hospitalisation
Delirium
48
Complications of delirium
Increased risk of dementia | Increased risk of further delirium
49
Ddx for delirium
Drug/alcohol withdrawal Mania Dementia
50
Ix for delirium
4AT AMT ``` U&E's FBC Blood gas Urine dipstick PR Glucose Cultures LFT ECG CT CXR LP ```
51
Is a higher or lower score worse in 4AT
Higher
52
Is a higher or lower score worse in the AMT
Lower
53
What morbidity and mortality complications is delirium associated with
Increased risk of death Longer length of stay Increased rates of institutionalisation Persistent functional decline
54
Describe features of hyperactive delirium
Agitated and upset Tend to cause more disturbance eon the ward Are far more obvious therefore far easier to identify
55
Describe features of hypoactive delirium
Drowsy and withdrawn Tend to sleep a lot A lot less obvious and therefore far more commonly missed
56
Other less key features of delirium
``` Disturbance of sleep wake cycle Disturbed psychomotor behaviour Emotional disturbance (agitation) Delusions Change in appetite ```

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