Which of the following is a feature of delirium that can help differentiate it from dementia quizlet?
|
Topic Resources
Delirium Delirium Delirium is an acute,
transient, usually reversible, fluctuating disturbance in attention, cognition, and consciousness level. Causes include almost any disorder or drug. Diagnosis is clinical... read more (sometimes called acute confusional state) and
dementia Dementia Dementia is chronic,
global, usually irreversible deterioration of cognition. Diagnosis is clinical; laboratory and imaging tests are usually used to identify treatable causes. Treatment is... read more are the most common causes of cognitive impairment, although affective disorders (eg, depression) can also disrupt cognition. Delirium and dementia are separate disorders but are sometimes difficult to distinguish. In both, cognition is disordered; however, the following helps
distinguish them: Delirium affects mainly attention. Dementia affects mainly memory.
Delirium often develops in patients with dementia. Mistaking delirium for dementia in an older patient—a common clinical error—must be avoided, particularly when delirium is superimposed on chronic dementia. No laboratory test can definitively establish the cause of cognitive impairment; a thorough history and physical examination as well as knowledge of baseline function are essential.  Click here for Patient Education Copyright © 2022 Merck & Co., Inc., Rahway, NJ, USA and its affiliates. All rights reserved. D. 65-year-old African American man with hypertension. Nonmodifiable risk factors for stroke include age (older than 65 years), male gender, ethnicity or race (incidence is highest in African Americans; next highest in Hispanics, Native Americans/Alaska Natives, and Asian Americans; and next highest in white people), and family history of stroke or personal history of a transient ischemic attack or stroke. Modifiable risk factors for stroke include hypertension (most important), heart disease (especially atrial fibrillation), smoking, excessive alcohol consumption (causes hypertension), abdominal obesity, sleep apnea, metabolic syndrome, lack of physical exercise, poor diet (high in saturated fat and low in fruits and vegetables), and drug abuse (especially cocaine). Other risk factors for stroke include a diagnosis of diabetes mellitus, increased serum levels of cholesterol, birth control pills (high levels of progestin and estrogen), history of migraine headaches, inflammatory conditions, hyperhomocystinemia, and sickle cell disease. Upgrade to remove ads Only SGD 41.99/year
Terms in this set (144)What is the DSM V proper term for DELIRIUM and DEMENTIA? Major neurocognitive disorders What did DSM V classification of "Major Neurocognitive Disorders" replace? Delirium and dementia
What is DELIRIUM in terms of: 1) Altered consciousness What is the MAIN GOAL of delirium treatment? Why? Delirium usually caused by some other medical condition so goal is to TREAT THAT condition and therefore eliminate the delirium In terms of DEMENTIA, describe: 1) Slow and insidious What type of memory loss is more common in dementia, especially early stage? Short-term memory loss When does HIGHER CORTICAL FUNCTIONING get affected in dementia usually? Later stages Describe the difference between DELIRIUM and DEMENTIA in terms of: DELIRIUM DEMENTIA Is DELIRIUM or DEMENTIA usually more sudden in onset? Delirium Is DELEIRIUM or DEMENTIA usually associated with definitive end point? Delerium Is DEMENTIA or DELIRIUM associated with permanent condition? Dementia Is DEMENTIA or DELIRIUM usually associated to another medical condition or underlying cause? Delirium Is DEMENTIA or DELIRIUM usually associated to being reversible? Delirium Is DEMENTIA or DELIRIUM usually worse at night? What is this called? - Both (but more likely to be delirium) Is DEMENTIA or DELIRIUM associated with altered consciousness? - Delirium (though can be for dementia later stages) Is DEMENTIA or DELIRIUM usually disoriented to time and place? Dementia Is DEMENTIA or DELIRIUM characterized by incoherence and inappropriate use of language? Delirium Is DEMENTIA or DELIRIUM characterized by loss of words? Dementia Is DELIRIUM or DEMENTIA characterized by short-term memory loss often? Dementia Is DELIRIUM or DEMENTIA more indicated for immediate medical attention? Delirium In terms of DELIRIUM DSM V DEFINITION describe: 1) Disturbance in ATTENTION In terms of DELIRIUM
TYPES, describe what is: 1) Intoxication via a substance causing delirium What is the NUMBER ONE cause of delirium in a hospital? * VERY IMPORTANT* Medication-induced delirium What are FIVE types of delirium? 1) Substance intoxication delirium What must you specify (2) with delirium? 1) Specify if ACUTE (few hours to days) or PERSISTENT (weeks to months) True/False: Delirium always include hyperactivity False (can be hypoactivity, hyperactivity or even mixed) What type of delirium lasts several weeks? Persistent What type of delirium lasts three days? Acute What is DELIRIUM considered in medicine? Why? - Medical emergency True/False: Delirium is considered a medical emergency True Describe DELIRIUM'S EFFECT on: 1) Increases In terms of DELIRIM, describe: 1) 15 - 60% What is the number one consult in psychiatry? Delirium In terms of PREDISPOSING FACTORS of DELIRIUM, describe: 1) Older age means more likely to get delirium What type of medications often give DELIRIUM? * VERY IMPORTANT * Anticholinergics What type of disabled people are likely to get dementia? Those who are socially isolated like DEAF or BLIND Do older or younger people tend to have delirium? Older What is the single most common pharmacological cause of delirium? * VERY IMPORTANT * Anticholinergic medicines In terms of the COURSE of delirium, describe: 1) Hours to days What is usually the cause of delirium? Some underlying medical condition In terms of ASSOCIATED FEATURES of DELIRIUM, describe: 1) Disturbances in
sleep-wake cycle (no idea if it is day or night and sundowning) In terms of DELIRIUM CAUSES, describe the common reversible factors D - Drugs (prescription and illicit) Delirium caused by DELIRIUM How can DEHYDRATION cause DELIRIUM? There is electrolyte imbalance Withdrawal from what three things often causes delirium? - Alcohol Describe the difference in possibilities for UTI for elderly and young people? - In young people, usually just causes discomfort and can be treated relatively easily What is the number 1 cause of reversible delirium? Medication Many times, things that affect the _______ cause delirium central nervous system (CNS) What is the most common infection that causes delirium? UTI True/False: A head injury can lead to delirium but not dementia False (Can lead to both delirium or dementia) A person with dementia is more prone to get ______ than a "normal person" - delirium True/False: Hyperthyroidism or hypothyroidism can both lead to delirium True Hyperthyroidism leads to _______ delirium hypoactive In terms of blood sugar, ______ or _____ can lead to delirium - hypoglycemia Essentially, any ______ in the body can lead to delirium abnormality
Are tumors more likely to lead to dementia, delirium or both equally? Dementia What are two types of PRIMARY BRAIN tumors? What are they likely to lead to: dementia or delirium? Which one is treatable and which one is not as responsive to therapy? - Meningioma and glioma What is DEMENTIA PUGILISTICA? People with repeated head trauma (i.e boxers) more likely to get dementia What type of dementia do boxers normally get? Why? - Dementia pugilistica What is an important factor to consider in terms of DELIRIUM and DEMENTIA? Environment Describe how the HOSPITAL SETTING can affect delirium? What should be done to help this? - The hospital environment (i.e busy nature of ICU) can cause psychosis/delirium In terms of a MEDICAL WORK-UP of DELIRIUM, describe: 1) History and physical In terms of TREATING DELIRIUM, describe: * VERY IMPORTANT * 1) Treat the underlying cause (i.e treat the low sodium or something else thought to cause it) What drug is often given to delirious patients to treat it? What route and why? What is the caveat? * VERY IMPORTANT * - Often given IV HALOPERIDOL True/False: In all cases of delirium, IV haloperidol can be used as symptomatic treatment False (in all cases but alcohol/benzodiazepine withdrawal in which case you give benzodiazepine in tapered levels) In terms of DELIRIUM, what is it symptomatically treated with? Describe frequency. Describe different doses - IV haloperidol (unless alcohol or benzodiazepine withdrawal then taper patient with benzodiazepine)
What is the drug of choice for DELIRIUM patients? What can be used if PO is an option often? - IV haloperidol If someone is going through ALCOHOL WITHDRAWAL and has DELIRIUM, describe: 1) CIWA
score What are NON-MEDICATION important things to do in treatment of delirium (4)? - Reorient patient (say nurses name, doctors name, clock in room etc) In
terms of MAJOR NEUROCOGNITIVE DISORDER, describe: 1) Dementia What is key to remember about the cognitive decline in DEMENTIA patients (2)? * VERY IMPORTANT * - It is a decline from previous baseline If someone gets confused because of polypharmacy, is that DEMENTIA or DELIRIUM probably? Delirium What is something similar to dementia but caused because of depression? Is this considered to be a type of dementia? - Pseudodementia What is PSEUDODEMENTIA? Dementia-like symptoms caused by depression What TWO things should be specified in MAJOR NEUROCOGNITIVE DISORDERS (aka dementia)? - Specify WITH or WITHOUT behavioral disturbances
If someone with dementia has behavioral disturbances caused by the frontal lobe they might try to ______ or be _____ - expose themselves What is the most COMMON type of dementia? Alzheimer's disease What is another name for PICK'S DISEASE? What happens? -
Frontotemporal lobar degeneration What is another term for FRONTOTEMPORAL LOBAR DEGENERATION? Pick's disease What is the SECOND MOST common form of dementia? Vascular disease causing dementia What is the first and second most common form of dementia? - FIRST is Alzheimer's Disease What is characteristic of the SECOND MOST common type of dementia? What is it called? - Stepwise decline in cognitive function due to multiple strokes True/False: HIV/AIDS cannot cause dementia False (it can if it gets into CNS) What is an example of a PRION DISEASE that causes DEMENTIA? Crutzfield- Jakub True/False: Dementia can be caused by Huntington's Disease True In terms of MILD NEUROCOGNITIVE DISORDER, describe what it is Cognitive and memory problem is more modest and doesn't affect ability to live independent but WORSE than normal aging Describe difference between normal aging and the two types of neurocognitive disorders NORMAL AGING MINOR NEUROCOGNITIVE DISORDER MAJOR NEUROCONGITIVE DISORDER (i.e dementia) In terms of DEMENTIA, describe: 1) Acquired True/False: Some dementia types are more likely to have early onset while some are likely to have late onset True In terms of EARLY FEATURES of DEMENTIA, describe: 1) Personality In terms of EARLY DEMENTIA, what signs are seen (4)? Are these very noticeable? - Subtle changes in personality, emotional affect decreased, subtle changes in intellect, decreased interest ranges In terms of LATER FEATURES of DEMENTIA, describe: 1) Pronounced
cognitive impairment Are more noticeable changes seen in EARLY or LATE dementia? Late In terms of ADVANCED DEMENTIA, describe: 1)
Activities of daily living (ADL) Differentiate generally the three stages of DEMENTIA EARLY LATER ADVANCED What can usually indicate death within a year for DEMENTIA patients? When they go mute/unresponsive In terms of PSEUDODEMENTIA, describe: 1) Dementia In terms of DEMENTIA vs PSEUDODEMENETIA describe: DEMENTIA PSEUDODEMENTIA
Are DEMENTIA or PSEUDODEMENTIA patients more likely to complain about memory problems? Pseudodementia If a patient responds with "I don't know" to every question, he or she probably has ______ * VERY IMPORTANT * pseudodementia Are PSEUDODEMENTIA or DEMENTIA patients more likely to lose social skills early on? Pseudodementia In terms of DIAGNOSING DEMENTIA, describe what three tests are done, what the scores mean and when should they be done - MSE, MMSE or MoCA In terms of DEMENTIA DIAGNOSTIC WORK UP, describe what should be done? Similar to delirium in which you do battery of tests What does RPR-VDLR test for? Nuerosyphyllis When should a CT/MRI be done for DEMENTIA patient? Suspected mass lesion When should EEG be done for DEMENTIA patients? Suspected or known seizures When should ABG be done for DEMENTIA patients? Respiratory impairment True/False: A SPECT or PET scan is a common test to run for dementia patients False (not common since not that valuable and it is expensive) In terms of ADVANCED ALZHEIMER'S DISEASE, we see _______ of brain matter general wasting away In terms of DEMENTIA, what is helpful for testing? What is the caveat though? Why is it helpful? - Neuropscyhological testing What is NEUROPSYCHOLOGICAL TESTING used for? What type of patients is it good for? - Helps determine baseline function for comparasion later and helps tell what type of dementia What type of testing is helpful to evaluate HIGHLY EDUCATED patients? Neuropsychological testing What is the DSM V name for the most common type of dementia? Major neurocognitive disorder of the Alzheimer's type In terms of ALZHEIMER'S DEMENTIA, describe: 1) Major neurocognitive disorder of the Alzheimer's type What is the difference, if any, between Alzheimer's dementia onset? - EARLY onset is usually before 65 (usually familail with problems in chromosme 21, 14 or 1) What type of ALZHEIMER'S DEMENTIA would early onset be related to? What age does this happen usually? - Familial (i.e problems with chromsomes 21, 14 or 1) In terms of ALZHEIMER'S DEMENTIA, describe: 1) Insidious (gradual and progressive) over months and years Is cortical atrophy seen in LATE or EARLY Alzheimer's dementia? Late Is hyerreflexia and frontal release signs seen in EARLY or LATE Alzheimer's Dementia? Late How can a definitive diagnosis of Alzheimer's Dementia be done? Post-mortem brain biopsy True/False: Imaging can tell you definitively the diagnosis of Alzheimer's Dementia False (must do post-mortem biopsy) What are FIVE definitive things that tell you diagnosis of Alzheimer's Dementia? ALL FROM POST-MORTEM BRAIN BIOPSY What type of neurons are often lost in ALZHEIMER'S PATIENTS? Where? - Cholinergic neurons In terms of ALZHEIMER'S DEMENTIA, describe risk factors in terms of: 1) History of head injury What chromosomal abnormality often causes people to be more predisposed to Alzheimer's Disease? Down's syndrome What is the relation between CHROMOSOME 19 and ALZHEIMER'S DISEASE? Presence of APOE e4 allene on chromosome 19 causes INCREASED RISK and EARLIER ONSET of Alzheimer's Dementia1_ In terms of DEMENTIA WITH LEWY BODIES, describe: 1) Alzheimer's Disease What type of dementia is characterized by severe VISUAL HALLUCINATIONS early on along with resting tremors and shuffling gait? What should not be given to them and why? - Lewy body dementia In terms of PICK'S DISEASE, describe: 1) Frontotemporal dementia Differentiate PICK'S DISEASE, ALZHEIMER"S DEMENTIA and LEWY BODY DEMENTIA ALZHEIMER'S DISEASE LEWY BODY DEMENTIA PICK'S DISEASE (FRONTOTEMPORAL LOBE DEMENTIA) In terms of HUNTINGON'S DISEASE, describe: 1) Autosomal dominant and involves short arm of chromosome 4 How does HUNTINGTON's DISEASE resemble dementia in later stages? What is a difference? - Significant cognitive impairment What disease is characterized by increased sucidal thoughts and chorieform movements? What is the basis of this disease? - Huntington's disease In terms of CRUETZFELDT-JAKOB DISEASE, describe 1) Rare What is a REVERSIBLE cause of dementia? - Vascular dementia In terms of VASCULAR DEMENTIA, describe: 1) Second most common What is the second most common type of dementia? Vascular dementia A patient comes in with a step-like fashion degeneration that resembles dementia. What type is it probably? How would you treat it? - Vascular dementia What is disease that causes incontinence, dementia and ataxia? Normal pressure hydrocephalus In terms of NORMAL PRESSURE HYDROCEPHALUS, describe: 1) Incotinence, ataxia
and dementia (Wet, wobbly and weird) A patient comes in with ataxic gait and incontinence. He also has cognitive impairment and memory problems. What would be a good treatment plan and why? - Shunt True/False: HIV or other infections can lead to dementia even in early stages of the infection True Describe the differentiation in metabolic disorders causing DEMENTIA and DELIRIUM - Acute metabolic disorders lead to DELIRIUM What is a beneficial treatment for EARLY DEMENTIA? What must be explained to the family? What three drugs are used normally? What is no longer used and why? - Cholinergic therapies (i.e cholinesterase inhibitors) What is another possibly beneficial treatment for dementia? What is an example? - NMDA receptor agonist Sets with similar terms
PHA 529 Exam 3-Distinguishing The Most Common Deme…93 terms rachel_coursey8 Dementia, Delirium and Amnestic Disorders26 terms AmyKidd23 Alzheimer Disease Case12 terms Fabiola_Desrosiers Dementia, Alzheimer's Disease, and Hearing Loss22 terms WhitneyMGrant Sets found in the same folderAnxiolytics, Sedatives and Muscles Relax…110 terms nitin101 Introduction to Clinical Neurology II87 terms nitin101 Genetic Disease Impacting the Nervous Sy…115 terms nitin101 Mycology 1: General Characteristics of Fungi99 terms nitin101 Other sets by this creatorSurgery Shelf Holliday664 terms
nitin101 Review110 terms nitin101 Pediatrics38 terms nitin101 Neuro40 terms nitin101 Other Quizlet setsExam 1 Content100 terms kelseyjadewong Lesson 10 Review Questions11 terms rachelyanezzambrano Patho Module Quizzes UNIT #147 terms Selena0186 Related questionsQUESTION What are some risk factors for vulvovaginal infections? 6 answers QUESTION What is the normal sleep pattern for newborns? 6 answers QUESTION An older adult client has been ordered to receive the drug warfarin (Coumadin). The nurse's primary intervention involves monitoring the client for drug toxicity by daily review of his: 7 answers QUESTION Who are at risk for glaucoma? 6 answers Which of the following is a feature of delirium that can help differentiate it from dementia?Delirium and dementia are separate disorders but are sometimes difficult to distinguish. In both, cognition is disordered; however, the following helps distinguish them: Delirium affects mainly attention. Dementia affects mainly memory.
How can you differentiate symptoms of delirium from dementia?Memory: One of the major differences between delirium and dementia is that, while delirium affects attention and concentration, dementia is primarily associated with memory loss.
What is the most distinguishing characteristic of delirium?Delirium is characterized by an acute change (usually over hours to days) in mental status. Patients demonstrate fluctuating levels of consciousness that they often manifest by periodically falling asleep during an interview.
What are 3 characteristics of delirium?The CAM diagnostic algorithm evaluates four key features of delirium: 1) Acute Change in Mental Status with Fluctuating Course, 2) Inattention, 3) Disorganized Thinking, and 4) Altered Level of Consciousness.
|
