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38 Cards in this Set

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Delirium
rapidly develping, fluctuating state of reduced awareness
Particular issues connected to delirium
Trouble shifting or focusing attention, At least one defect of memory, orientation, perception, or language, Symptoms not better explained by a dementia
Causes of Delirium
General medical condition, Substance induced, Multiple etiologies, NOS
Dementia
Memory loss & other cognitive deficits
Name particular cognitive deficits with dementia
Amnesia, Aphasia, Apraxia, Agnosia, Loss of executive functioning
More issues related to dementia
Inability to focus or shift attention is not prominent
More issues...dementia
Cause can usually be found in CNS (with delerium cause is elswhere in body)
More issues...dementia
Dementia is relatively fixed (unchanging)
More issues...dementia
Patients seldom recover from a dementia
Types of Dementia
Alzheimers: begins gradually, progresses inevitably (more than half of dementias are this type)
Types...dementia
Vascular: vascular brain disease, memory and other cogntive losses with sudden onset and fluctuating course (10-20% are this type)
Types...dementia
Other General Medical Conditions: tumor, Creutzfeldt-Jakob disease (virus), HIV, Huntingdon's, etc. (most common kidney, liver failure)
Types...dementia
Substance-induced Persisting: 5-10% this type. Prolonged use of alcohol, inhalants, sedatives
Types...dementia
Multiple Etiologies: More than one of the above causes, ex. abuses substance with general medical condition
Types...dementia
Not otherwise specified: Patient demented for no known reason
Amnestic Disorder
Fancy term for "amnesia"
Main features...Amnestic disorder
No requirement for reduced ability to focus or shift attention
Main features...Amnestic
Memory affected far more than any other function, ex. pt. forgets conversations of a few minutes ago
Main features...Amnestic
Early in illness, patients try to hide loss of memory by making up memories
Types of...Amnestic disorders
General Medical Condition: symptoms resemble Korsakoff's syndrome but there is a medical cause (stroke, head trauma, etc)
Types of...Amnestic
Substance-induced: Popularly known as Korsakoff's syndrome. Classical amnestic alcoholic who suffers from Vit. B1 (thiamine) deficiency
Name other causes of cognitive symptoms. Describe below.
Age-related cognitive decline, dissociative disorders, pseudodementia, malingering, factitious disorder with psychological signs and symptoms
Age-related cognitive decline?
Decline consistent with aging and not pathological: Ex. remembering names, phone numbers, where they put things, etc.
Dissociative Disorders?
Profound, temporary loss of memory: Ex. Diss. Amnesia, Diss. Fugue, DID
Pseudodementia?
Apathy and slowed responses, show memory loss and other symptoms of dementia but is rather a severe MDD (accounts for 5% of elderly patients tested for dementia)
Malingering?
Intentional exaggeration or falsification of cognitive symptoms to obtain funds or avoid punishment or military service.
Define cognitive deficits that present with dementia.
Amnesia, Aphasia, Apraxia, Agnosia, Loss of executive functioning, Confusion
Amnesia
Loss of memory (retrograde-prior to a certain time, Anterograde-unable to form new memories)
Aphasia
Disturbance of language use
Apraxia
Inability to perform a motor behavior although nerves and muscles required for this behavior are intact
Agnosia
Inability to recognize familiar objects, though senses required for recognition are intact
Loss of executive functioning
Difficult in planning, organizing, sequencing or abstracting information
Confusion
Slowed thinking, loss of memory, or disorientation in patients with cogntive disorders
Define Substance-Related Disorder
Mind-altering through the use of substances: 4 types are dependence, abuse, intoxication, withdrawal
Define Substance Dependence
User has taken a substance frequently enough to produce clinically important distress or impaired functioning as well as cerain behavioral characteristics (all classes of drugs but caffeine).
Define Substance Abuse
This is a residual category (i.e. diagnosis of last resort) for patients whose substance use produces problems but does not fulfill the more rigorous criteria for Substance Dependence (all substances but caffeine and nicotine).
Define Substance Intoxication
Acute clinical condition resulting from recent overuse of a substance. All drugs but nicotine have a specific syndrome of intoxication.
Define Substance Withdrawal
Symptoms which develop when a person who has frequently used a substance discontinues or markedly reduces the amount used. All substances except caffeine, cannabis, PCP, the hallucinogens and inhalants have a withdrawal syndrome.