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Pathopharmacology Fundamentals > Wk 4 Dementia & Delirium > Flashcards

Wk 4 Dementia & Delirium Flashcards

(88 cards)

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1
Q

Acute confusional state, aka organic brain syndrome

A

Delirium

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2
Q

Delirium is a transient disorder of… (3)

A

Cognitive function, consciousness, or perception

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3
Q

Delirium is typically acute and

A

associated with other medical conditions

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4
Q

__ withdrawal can contribute to delirium

A

Alcohol

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5
Q

Metabolic disorders such as __ can contribute to delirium

A

hypoglycemia

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6
Q

Increased accumulation of __ from liver or kidney failure can contribute to delirium

A

Metabolites

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7
Q

These three things can contribute to delirium

A

Brain surgery, tumors, trauma

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8
Q

Post __ can contribute to delirium

A

Anesthesia

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9
Q

These three states can contribute to delirium

A

Fever, electrolyte imbalances, dehydration

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10
Q

Acute disturbance in attention or awareness

A

Hyperactive delirium

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11
Q

Hyperactive delirium typically develops over

A

2-3 days

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12
Q

Hyperactive delirium is commonly seen in

A

ICUs, post op, withdrawal, and hospitalized elderly

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13
Q

Risk factors for hyperactive delirium

A

medications like bentos or narcotics, acute infection or sepsis, hypoxia, electrolyte and metabolic dysfunction, insomnia

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14
Q

Hyperactive delirium is related to…

A

Autonomic nervous system overactivity

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15
Q

What symptoms does someone with hyperactive delirium have?

A

Restless, irritable, can’t concentrate, can’t sleep, poor appetite, tremors

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16
Q

Severe delirium is called

A

Fully developed delirium

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17
Q

Patients with fully developed delirium

A

Hallucinate, completely inattentive, can’t pay attention to what’s going on, can’t rationalize, can’t be brought into reality, high levels of restless movement, dilated pupils, fever, diaphoretic

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18
Q

If can’t control developed delirium it can turn into

A

Excited delirium syndrome

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19
Q

Excited delirium syndrome: The patient becomes

A

Combative, aggressive, pain, tachypnea, can cause death!

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20
Q

Excited delirium syndrome most common in…

A

Mental illness or prior mental illness

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21
Q

Excited delirium syndrome less common in..

A

the elderly but it can occur

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22
Q

Treatment for excited delirium syndrome

A

Try to remove the risk factors, try to help them sleep, medications

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23
Q

Excited delirium syndrome usually resolves in

A

2-3 days, but can persist for weeks, especially if still hospitalized

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24
Q

Hypoactive delirium most associated with

A

right-sided frontal basal ganglion disruption

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25
Hypoactive delirium affects the part of the brain associated with
Coordinated movements and alertness
26
Hypoactive delirium most common in metabolic disorders such as
Liver and kidney failure, build up of metabolites
27
Someone with hypoactive delirium presents with
Decreased alertness and attention span, decreased perception of the environment, slow speech, sleepy, apathetic
28
Hypoactive delirium aka
Catatonic
29
Goal to treat delirium
Identify cause and remove causative agents, modify risk factors when can
30
If a patient has dementia, they have a
much higher risk of becoming delirious
31
Delirium can be
prevented!
32
Can give __ for hyperactive delirium for the risk factors that we cannot do anything about
antipsychotics, these are short term treatments
33
If delirium persists for weeks...
It needs to be followed up by the HCP because it's not delirium anymore
34
Delirium age
Usually older
35
Delirium onset
Actue, hospitalizations
36
Delirium associated conditions
UTI, thyroid disorder, hypoxia, hypoglycemia
37
Delirium course
Fluctuating, reversible
38
Duration of delirium
hours, days, sometimes months
39
Delirium attention
Inability to focus or sustain attention
40
Delirium sleep wake is
disrupted
41
Behavior of someone with delirium
Agitated, withdrawn, depressed
42
Speech pattern of someone with delirium
Incoherent, disorganized
43
Thoughts and perceptions of someone with delirium
Disorganized, delusions, hallucinations
44
Dementia is an...
Acquired deteriorated and progressive failure of cognitive function
45
Dementia cognitive processes affected
Memory, language, judgement, decision making,
46
Dementia patients may present
Agitated, frustration, wandering, aggression
47
Pathophysiology of dementia
neuron degeneration, compression of brain tissue
48
In dementia there is atherosclerosis
in cerebral vessels
49
Possible causes of dementia
Brain trauma, infection, neural inflammation
50
Two infections that can contribute to dementia
HIV and Cruetzfeldt Jakob disease
51
Onset of dementia
Slow onset, irreversible
52
Manifestations of dementia disease
Memory loss, decrease LOC, overall slowing
53
No cure for dementia, treatment aimed at
Restoring and optimizing function, such as OT
54
Alzheimer's disease accounts for __ % of dementia
50-75%
55
Vascular dementia accounts for __% of dementia
20-30%
56
Lewy body dementia accounts for __% of dementia
10-25%
57
Frontotemperal accounts for __% of dementia
10-15%
58
A lot of dementia is
Mixed, can have more than one type at once
59
Leading cause of severe dysfunction in the elderly
Alzheimer's disease
60
Being a woman makes you
much more likely to get Alzheimer's disease, 2/3 are women
61
Genetic Alzheimers associated with
early onset
62
Sporadic late onset Alzheimer's
Older age, more common, not exact genetic association
63
Alzheimer's is a
rule out disease
64
Clinical criteria for Alzheimer's disease
Mental status exam, brain imaging
65
Risk factors for Alzheimer's
Older than 65, family history, existing cognitive impairment, drinking, smoking, unhealthy diets, previous head trauma, and social isolation
66
Alzheimer's pathophysiology: Accumulation of
neuritic plaques (Amyloid) and intraneuronal neurofibrillary tangles of tau protein
67
Alzheimer's pathophysiology: Tau protein is a key factor that...
Accelerated nerve degeneration
68
Alzheimer's pathophysiology: Neuritic plaques disrupt
nerve impulse transmission and kill neurons
69
Alzheimer's pathophysiology: Neuritic plaques more centralized in the...
cerebral cortex and hippocampus, these are typically associated with memory
70
Alzheimer's pathophysiology: These contribute to memory and cognitive decline
Loss of synapses, decreased acetylcholine, and other neurotransmitters
71
Alzheimer's pathophysiology: Loss of neurons leads to
brain atrophy
72
Alzheimer's pathophysiology: All of these changes occur
decades prior to symptoms
73
Initial manifestations of Alzheimer's disease
Subtle, difficult to identify, typically progressively more difficult to remember current events
74
Alzheimer's patients eventually end up in a
Nonverbal vegetative state, and it leads to death
75
Second most common type of dementia
Vascular, related to CVD
76
Vascular dementia related to...
CVD, CAD, cardioembolism, small vessel disease, stroke... all causing hypoperfusion to the brain
77
Risk factors for vascular dementia
DM, HTN, hyperlipidemia, smokers
78
Treatment for vascular dementia
treat the risk factors
79
Frontotemporal dementia
really, rare, used to be known as pick disease
80
Age of onset for frontotemporal dementia
Less than 60
81
Frontotemporal dementia is related to
Gene mutations of encoding the tau protein
82
3 distinct clinical syndromes of frontotemporal dementia
Behavioral variant, progressive non-fluent behavior, semantic dementia
83
Semantic dementia
Problems forming words and sentences
84
Behavioral variant dementia
changes in personality
85
Progressive non-fluent behavior dementia
Problems with language and writing skills
86
How do you test for frontotemporal dementia?
Genetic testing
87
Treatment for frontotemporal dementia
There is none
88
Dementia onset
insidious and progressive

Pathopharmacology Fundamentals (13 decks)

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