Neurocognitive Disorders Flashcards
(23 cards)
What is the first criterion for diagnosing delirium according to DSM-5?
A disturbance in attention accompanied by a reduced awareness of the environment.
How quickly does the disturbance in delirium typically develop?
Over a short period of time, usually hours to a few days.
What additional disturbance is required for a delirium diagnosis?
An additional disturbance in cognition (e.g. memory deficit, disorientation, language).
What must be ruled out when diagnosing delirium?
Disturbances in attention and cognition are not better explained by another neurocognitive disorder.
What does Criterion E of delirium diagnosis entail?
Evidence that the disturbance is a direct physiological consequence of another medical condition, substance intoxication or withdrawal, or exposure to a toxin.
What are the subtypes of delirium based on duration?
- Acute: Lasting a few hours or days
- Persistent: Lasting weeks or months
What characterizes hyperactive delirium?
Hyperactive level of psychomotor activity, mood lability, agitation, and/or refusal to cooperate.
What are common features of delirium?
- Disturbance to attention
- Sleep/wake disturbances
- Psychotic-like symptoms
- Affective symptoms
- Shifts in psychomotor activity
What are some risk factors for developing delirium?
- Polypharmacy
- Infection
- Dehydration
- Malnutrition
- Hospitalization
- Old age
- Severe illness
Which assessment tools are used for delirium?
- Confusion assessment method
- MoCa/MMSE
What is the first step in managing delirium?
Identify and treat the underlying cause.
What is the recommended pharmacotherapy for delirium?
Low dose, high potency antipsychotics, such as Haloperidol.
What is the prognosis for delirium?
Up to 50% one-year mortality rate.
What does the acronym ‘I WATCH DEATH’ represent in the aetiology of delirium?
- Infectious
- Withdrawal
- Acute metabolic disorder
- Trauma
- CNS pathology
- Hypoxia
- Deficiencies
- Endocrinopathies
- Acute vascular
- Toxins
- Heavy metals
What are the DSM-5 criteria for Major Neurocognitive Disorder?
Significant cognitive decline in one or more cognitive domains, interfering with independence in everyday activities, not occurring exclusively in delirium, and not better explained by another mental disorder.
What is the lifetime risk of developing Major Neurocognitive Disorder for men and women at middle age?
1:6 for men, 1:5 for women.
What are the 7 A’s of dementia?
- Amnesia
- Aphasia
- Apraxia
- Agnosia
- Agnosognosia
- Apathy
- Altered perception
What percentage of dementia cases is attributed to Alzheimer’s disease?
50-70%.
What characterizes Frontotemporal degeneration?
Language type and behavioral type with early preservation.
What are the common symptoms of Lewy body disease?
- Early changes in executive and attention
- Well-formed visual hallucinations
- Fluctuating cognitive impairment
What is a key feature of Vascular Dementia?
Abrupt onset and stepwise progression.
What imaging is recommended for assessing dementia?
CT head if focal deficit, acute change, or specific patient criteria.
What pharmacological therapies are used to manage Alzheimer’s disease?
- Cholinesterase inhibitors (donepezil, rivastigmine, galantamine)
- Low-dose atypical antipsychotics (olanzapine, quetiapine, risperidone)
