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32 Cards in this Set

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problems with memory and orientation x 3, level of consciousness and other thinking functions
cognitive disorders
cognitive disorder sx are caused by
abnormal neural chemistry, structure or physiology
3 major cognitive disorders
delirium, dementia and amnestic disorder
major difference between normal aging and presence of cognitive disorder
normally aging pts are able to care for themselves and carry on a normal life
common sx of elderly depressed pts; called ___
decreased concentration and speed of mental process; pseudodementia
syndrome of cognitive impairment that results from CNS dysfunction; characterized by clouding of consciousness
delirium
delirium presents in which type of setting?
course of an acute medical illness
Dx: no consciousness impaired, sad mood, slow onset, little ANS dysfunction, normal arousal and EEG, no delusions/hallucinations, AM diurnal variability
depression
Dx: impaired consciousness, quick onset, delusions/hallucinations, ANS dysfunction
delirium
Dx: no consciousness impaired, slow onset, normal arousal/ANS dysfunction, no delusions/hallucinations, little diurnal variability, loss of intelectual ability
dementia
disorder characterized by gradual loss of memory and intellectual function w/o impaired consciousness
dementia
types of dementia
alzheimer's, vascular, Lewy body, HIV
accumulation of beta-amyloid plaques and reduced levels of choline acetyltransferase in consistent with which cognitive disorder?
Alzheimer's
describe the progression of Alzheimer's in different parts of the brain
from temporal to frontal (onset of emotional sx) and parietal lobes
cholinesterase inhibitors (4)
donepezil, rivastigmine, galantamine, tacrine
NMDA antagonist; it's action
memantine; prevents overstimulation of NMDA receptor by glutamate
cognitive disorder caused by multiple, small cerebral infarctions resulting from athersclerosis, valvular heart disease or arrhythmias
vascular dementia
are there neurofibrillary tangles present with Lewy body dementia?
no
2 characteristics of Lewy body dementia impt to psychiatry:
+ psychotic sx occur and pts have adverse rxns to antipsychotic meds
fabrication of forgotten information in the case of amnesia
confabulation
primary cause of amnestic disorder is
thiamine deficiency secondary to alcoholism
destruction of mediotemporal lobe structures (mammillary bodies, hippocampus, fornix)
Korsakoff's syndrome
disorder characterized by sudden but temporary loss of memory or identity or feelings of detachment, normal level of consciousness
dissociative disorder
memory loss in dissociative disorders differs from that in cognitive disorders by:
cause is usually emotional
4 major classifications of dissociative disorders
amnesia, fugue, identity disorder and depersonalization
major DDx for dissociative disorders
PTSD
dissociative disorder that usually resolves in minutes to days
amnesia
dissociative disorder in which there is memory loss and leaving home to establish a different identity
fugue
fugue is often associated with the excessive use of what?
alcohol
dissociative disorder involving many alters in 1 indiv
identity disorder
dissociative disorder associated with repeated chronic feelings of detachment
depersonalization
tx of dissociative disorders
hypnosis, drug assisted interview, psychotherapy