Common presentation of Delirium - ANSWER First symptom of delirium is
impaired orientation.
MSE: Speech impairment, slurred and disorganized, highly inattentive.
Affect: can change from lethargic to agitated. They may have visual
hallucinations. Judgement is grossly impaired.
PE: tremors, incontinence, nystagmus, increased muscle tone.
Delirium Criteria - ANSWER A. A disturbance in attention and awareness.
B. A change in condition develops over a relatively short period of time (hours
to days) and tends to fluctuate throughout the day, and there is evidence of a
change from baseline attention and awareness.
C. An alteration in cognition, that is memory deficit, disorientation, language
disturbance, visuospatial ability, or perceptual distortion.
D. the disturbance in Criterion A and C are not better accounted for by another
pre-existing, established, or evolving neurocognitive disorder and do not occur
in the context of a severely reduced level of arousal, such as coma.
E. There is evidence from the history, PE, or lab findings that the disturbance is
a direct physiological consequences of another medical condition, substance
intoxication or withdrawal, or exposure to a toxin, or is due to multiple
etiologies.
Mnemonic for delirium criteria: Medical FRAT
M: Medical cause
F: Fluctuating course
R: Recent onset
A: Attention impairment
T: thinking impairment.
,NCD most common form of- ANSWER 50-60% have most common type,
Alzheimer's type.
Neurotransmitters in Alzheimer's Disease- ANSWER Acetylcholine and
norepinephrine hypothesized to be hypoactive in Alzheimer's.
Define: Paranoid personality disorder- ANSWER Long-standing suspiciousness
or mistrust.
Define: Borderline personality disorder; ANSWER A pattern of instability in
interpersonal relationships, self-image, and affects, and marked impulsivity.
Define: histrionic personality disorder: - ANSWER a pattern of excessive
emotionality and attention seeking.
Define: antisocial personality disorder: - ANSWER a pattern of disregard for,
and violation of, the rights of others.
Define: Dependent personality disorder: - ANSWER a pattern of submissive
and clinging behavior related to an excessive need to be taken care of.
Difference between delirium and NCD: - ANSWER Delirium:
It has an acute onset, developing over hours or days. It shows changes in the
level of consciousness, characterized by periods of hyper-vigilance alternating
with lethargy. It is reversible, Symptoms wax and wane over hours, several
times during the day. Dementia: It is a gradual, progressive illness that extends
over many years. The levels of consciousness are unaffected. It is irreversible.
Symptoms remain relatively constant. Behaviour remains relatively consistent
, from one day to another, except for an obvious change due to recent changes in
medical conditions or medications.
Delirium defined: - ANSWER Attention is impaired and all the cognitive
processes are therefore also impaired. Will have difficulty with the 3 object
recall task, as their attention is too impaired to register the words in the first
place. Auditory and visual hallucinations are common.
4 subcategories of causes of delirium: - ANSWER (1) general medical causes
(infection)
(2) substance induced
(3) multiple causes (head injury, kidney disease)
(4) other multiple etiologies (sleep deprivation, medication)
Define Dementia (NCD) - ANSWER attention is intact, but the cognitive
process, particularly memory, is impaired. Marked by severe impairment in
memory, judgement, orientation and cognition.
9 Subcategories of Dementia - ANSWER (1) Dementia of the Alzheimer's
type
(2) vascular dementia (thrombosis or hemorrhage)
(3) HIV disease
(4) head trauma
(5) Pick's disease
(6) Prion disease caused by slow growing transmittable virus.
(7) substance induced
(8) different aetiologies
(9) not specified
impaired orientation.
MSE: Speech impairment, slurred and disorganized, highly inattentive.
Affect: can change from lethargic to agitated. They may have visual
hallucinations. Judgement is grossly impaired.
PE: tremors, incontinence, nystagmus, increased muscle tone.
Delirium Criteria - ANSWER A. A disturbance in attention and awareness.
B. A change in condition develops over a relatively short period of time (hours
to days) and tends to fluctuate throughout the day, and there is evidence of a
change from baseline attention and awareness.
C. An alteration in cognition, that is memory deficit, disorientation, language
disturbance, visuospatial ability, or perceptual distortion.
D. the disturbance in Criterion A and C are not better accounted for by another
pre-existing, established, or evolving neurocognitive disorder and do not occur
in the context of a severely reduced level of arousal, such as coma.
E. There is evidence from the history, PE, or lab findings that the disturbance is
a direct physiological consequences of another medical condition, substance
intoxication or withdrawal, or exposure to a toxin, or is due to multiple
etiologies.
Mnemonic for delirium criteria: Medical FRAT
M: Medical cause
F: Fluctuating course
R: Recent onset
A: Attention impairment
T: thinking impairment.
,NCD most common form of- ANSWER 50-60% have most common type,
Alzheimer's type.
Neurotransmitters in Alzheimer's Disease- ANSWER Acetylcholine and
norepinephrine hypothesized to be hypoactive in Alzheimer's.
Define: Paranoid personality disorder- ANSWER Long-standing suspiciousness
or mistrust.
Define: Borderline personality disorder; ANSWER A pattern of instability in
interpersonal relationships, self-image, and affects, and marked impulsivity.
Define: histrionic personality disorder: - ANSWER a pattern of excessive
emotionality and attention seeking.
Define: antisocial personality disorder: - ANSWER a pattern of disregard for,
and violation of, the rights of others.
Define: Dependent personality disorder: - ANSWER a pattern of submissive
and clinging behavior related to an excessive need to be taken care of.
Difference between delirium and NCD: - ANSWER Delirium:
It has an acute onset, developing over hours or days. It shows changes in the
level of consciousness, characterized by periods of hyper-vigilance alternating
with lethargy. It is reversible, Symptoms wax and wane over hours, several
times during the day. Dementia: It is a gradual, progressive illness that extends
over many years. The levels of consciousness are unaffected. It is irreversible.
Symptoms remain relatively constant. Behaviour remains relatively consistent
, from one day to another, except for an obvious change due to recent changes in
medical conditions or medications.
Delirium defined: - ANSWER Attention is impaired and all the cognitive
processes are therefore also impaired. Will have difficulty with the 3 object
recall task, as their attention is too impaired to register the words in the first
place. Auditory and visual hallucinations are common.
4 subcategories of causes of delirium: - ANSWER (1) general medical causes
(infection)
(2) substance induced
(3) multiple causes (head injury, kidney disease)
(4) other multiple etiologies (sleep deprivation, medication)
Define Dementia (NCD) - ANSWER attention is intact, but the cognitive
process, particularly memory, is impaired. Marked by severe impairment in
memory, judgement, orientation and cognition.
9 Subcategories of Dementia - ANSWER (1) Dementia of the Alzheimer's
type
(2) vascular dementia (thrombosis or hemorrhage)
(3) HIV disease
(4) head trauma
(5) Pick's disease
(6) Prion disease caused by slow growing transmittable virus.
(7) substance induced
(8) different aetiologies
(9) not specified
