neurocognitive II: delirium

Question 1

delirium is commonly seen on

Answer 1

inpatient medical/surgical units and in extended care facilities

Question 2

delirium duration

Answer 2

last days to weeks

Question 3

delirium is associated with poor outcomes

Answer 3

• increased mortality
• institutionalization
• dementia

Question 4

delirium is a disturbance in ____ and ____

Answer 4

attention and awareness

Question 5

delirium clinical features

Answer 5

1. acute onset
2. fluctuating course “waxing and waning” lucid intervals
3. inattention

Question 6

psychomotor distubances in delirium

Answer 6

1. hyperactive
2. hypoactive
3. mixed

Question 7

hypoactive signs

Answer 7

harder to identify

- marked by lethargy

Question 8

delirium can be cause by medications but especially

Answer 8

anticholinergics

Question 9

anticholinergic syndrome

Answer 9

inhibition of Ach transmission in the parasympathetic nervous system (muscarininc)

Question 10

subdural hematoma can present as a quiet _____ delirium

Answer 10

hypoactive

Question 11

pathophysiology of delirium

Answer 11

• Nt deficiency/ excess

- neuroinflammatory events

Question 12

Nt in delirium

Answer 12

1. decrease in Ach
2. decrease in GABA
3. increase in Glutamate
4. increase in dopamine

Question 13

eeg in delirium

Answer 13

diffuse slowing

Question 14

delitium tremens

Answer 14

alcohol withdrawing

• low voltage fast activity waves

Question 15

hepatic encephalopathy

Answer 15

build up of ammonia

• triphasic waves s

Question 16

acute onset, remits with correction of underlying medical condition

Answer 16

delirium course

Question 17

slow onset, chronic progressive

Answer 17

dementia course

Question 18

memory impacientar

Answer 18

dementia

Question 19

fluctuating levels of consciousness with decreased attention

Answer 19

delirium

Question 20

is dementia a major risk factor for delirium?

Answer 20

yea

Question 21

what type of dementia can look like delirium due to fluctuating levels of arousal

Answer 21

lewy body dementia

Question 22

pharmacologic managment

Answer 22

1. antypsychotics by decreasing severity and duration

2. cholinesterase inhibtor but does not really work

Question 23

pharmacological management usually during their

Answer 23

agitated state

Question 24

elirium is characterized by which of the following neurotransmitter changes?

1. ↑ dopamine, ↑ Ach
2. ↓ dopamine, ↓ Ach
3. ↑ dopamine, ↓ Ach
4. ↓ dopamine, ↑ Ach

Answer 24

3.↑ dopamine, ↓ Ach

Question 25

When the underlying medical abnormality causing delirium is successfully addressed, the associated cognitive difficulties will always fully resolve.

Answer 25

ideally it is true

Question 26

Patients with dementia are more likely to experience delirium than patients without dementia.

Answer 26

true

Question 27

Which class of medication is most likely to be helpful for severely agitated patients with delirium? 1. Benzodiazepines 2. Antidepressants 3. Antipsychotics 4. Cholinesterase inhibitors

Answer 27

3.Antipsychotics

Question 28

Symptoms of delirium often fluctuate over the course of the day leading observers to occasionally mistakenly believe the patient has conscious control over their symptoms.

Answer 28

true