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24 Cards in this Set
- Front
- Back
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Delirium
Criteria |
rapid onset
recent memory loss rapid development with flucutations (night or quiet room) hypo ro hyper viligant (don't care about env or care too much) |
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Dementia (ex. Alz)
Characteristics general |
slow
memory loss going backwards awareness unchagned alertness normal |
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Dementia (ex. Alz)
Criteria - 4 |
one of following
aphasia apraxia - can't follow directions agnosia - can't name things disturbance in exec fxnt |
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Amnestic disorder
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rapid
recent memory loss awareness unchanged alertness normal impaires fxn no delirium or dementia |
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Delirium and Dementia
Epi |
80% terminally ill
lots 50-60% of eldery of people over 80, 20% |
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Determinant of Behavior Change
Organic |
extent of damage
rapid onset - acute is worse age of onset - same degree worse in older |
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Determinant of Behavior Change
Psychosocial |
if have rigid personality, can with stand organic assult (eg. more LSD to have trip)
Physical env: over/under stim; 'icu syndrome' anxiety or stress worse at night, great change over short time. |
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Mental Status Exam
Appearance |
highly agitated to stupor
distant and evasive! tentative gait |
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Mental Status Exam
Stream of thought |
tangentiality
circumstantialit dec complexity of sent pause to search for words NOT loose of assn |
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Mental Status Exam
Thought Content |
delusions - paranoid, involve local env; rarly bizzar or elaborate of schizo; Capgras or liliputhian
illusions - more common than hall hall - visual more often, frightening and unpleasant |
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Mental Status Exam
Mood/Affect |
labile, rapidly shifting moods
bluding affect depression; suicide possible |
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Mental Status Exam
Cog. Fxn |
impaired, not equally, fluctuates with time
define normal fxning |
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Mental Status Exam
Cog. Fxn Judgment and insight |
ask question and judge response
evasive anwers or wrong answer; appx. theater found envelop |
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Mental Status Exam
Cog. Fxn Orientation! |
time
place circumstance person they go in that order, rarely person |
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Mental Status Exam
Cog. Fxn Intellectual |
attn span decreases
fund of info - ask 3 unrelated objects calculations |
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Mental Status Exam
Cog. Fxn Intellectual calculations |
simple arithmetic - deficit; simple adding
serial 7s of 3s test memory or concentration word problems Alz don't admit have memory prob; |
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Mental Status Exam
Cog. Fxn Intellectual digit span word spelling |
recite list of numbers
start with 5 work to 7, only fail if miss twice do same task backwards; should get appx same number both ways spell WORLD fwd and back |
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Mental Status Exam
Cog. Fxn abstract thinking |
proverbs - not the best
look for concerete answers bizzar not expected ask similarities and differences between objects |
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Mental Status Exam
Cog. Fxn Memory |
3 items for 5 min or more
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Delirium and Dementia
Treatment |
Many things can be revesible
endocrine intracranial nutritional psych - with serious depression |
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Delirium and Dementia
Treatment Drugs Psycosis |
low dose haloperidol or non-sedating antipsychotics
no ativant |
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Delirium and Dementia
Treatment Drugs Agitation |
higher doses of non-sedating antipsychotics
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Delirium and Dementia
Treatment Drugs Depression |
antiD without sedative or antiChol side E (citalopram)
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Delirium and Dementia
Treatment Drugs AVOID |
meds. with sedative or antiACh effects. Caution with tranquilizers and hypnotics
Antipsychotics in elderly inc. risk of CV death |
