Dementia & Delerium Flashcards
Hypoactive delerium features
- withdrawal
- sleepiness
- confusion
- not eating and drinking
What are the features of encephalitis
- fever, headache, psychiatric symptoms, seizures, vomiting
- focal features e.g. aphasia
What is the pathophysiology of encephalitis
HSV-1 responsible for 95% of cases in adults
typically affects temporal and inferior frontal lobes
What investigations should be done if suspecting encephalitis
- CSF: lymphocytosis, elevated protein
- PCR for HSV
- CT: medial temporal and inferior frontal changes (e.g. petechial haemorrhages) - normal in one-third of patients
- MRI is better
- EEG pattern: lateralised periodic discharges at 2 Hz
What are the 4 main types of dementia
- Alzheimers
- Vascular
- Frontotemporal
- Lewy body
What are the 5 A’s of a dementia history
A: aphasia A: amnesia A: apraxia A: agnosia ADLs
What is Brocas aphasia
- Expressive aphasia
- Comprehension maintained but unable to form words
- Changes in frontal-temporal zone
What is wernikes aphasia
- Receptive aphasia
- Comprehension lost but able to form words
- Changes in the temporal lobe
What is Apraxia
- Impaired ability to carry out skilled motor activities
* Eg. Brushing hair, standing up
What is agnosia
• Difficulty in recognising objects and people
How do you risk assess for dementia
In the house • Gas on • Forgetting to eat Out the house • Driving • Wondering in dangerous places Leaving the house • Unlocked doors Returning to the house • Forgetting where they live
What investigations should you do before diagnosing dementia
Bloods: • FBC • U+E’s → look for low sodium • Calcium • LFTs • B12 and Folate • Glucose • CRP/ESR Urinalysis Imaging: CT/MRI
Key features of alzheimers
- Most common
- Gradual decline
Key features of vascular dementia
- Step wise decline, family can give idea when cognition declined.
- Will have risk factors for vascular disease
Key features of Lew body dementia
- Linked to Parkinson’s disease
* Hallucinations common
