Delerium & Dementia Flashcards

1
Q

Delirium DSM definition

A
  • disturbance in attention and awareness
  • disturbance develops over a short period of time
    • change from baseline attention
    • tends to fluctuate during course of day
  • additional cognitive disturbance
  • evidence that disturbance is a direct consequence of another medical condition
    • substance intoxication/withdrawal
    • toxin
    • multifactorial
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Possible underlying causes of delirium

A
  • infection
  • electrolyte abnormalities
  • hypoglycemia
  • cardiac/pulmonary/hepatic/renal failure
  • endocrine
  • medications
  • drugs, withdrawal
  • trauma
  • epilepsy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Delirium mechanism

A
  • Disrupted ascending activation from reticular activating system and thalamus to the cortex
    • both very sensitive to metabolic stress
  • •Potentially involving multiple transmitter systems: dopamine, acetylcholine, norepinephrine, and serotonin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Management of delirium

A
  • •Low dose Haldol; IV form
  • •May use low dose atypicals if PO
  • •Donepezil
  • •Unless EtOH withdrawal, avoid pitfalls of benzos and paradoxical agitation
  • •Physical restraints only during acute agitation and promptly removed
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Dementia DSM definition

A

A.Evidence of significant cognitive decline from a prior level of performance in one or more cognitive domains

B.Cognitive deficits interfere with independence in everyday activities

C.Do not occur exclusively in context of delirium

D.Not better explained by another mental disorder (i.e., depression, schizophrenia)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

General characteristics of dementia

A
  • “top-down” cognitive fxnl impairment
    • i.e. isolated memory problems w/out attention issues
  • decline from previous baseline
  • changes in personality, mood, perception
  • numerous causes:
    • neurodegenrative: Alzheimers
    • vascular
    • obstructive
    • neoplastic
    • infectious
    • trauma
  • depression can present as dementia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly