 | Term | Definition |
| |
Delirium |
Transient, organic/medical cause, acute onset, fluctuations (waxing & waning) |
| |
Predisposing Factors for Delirium |
75-85 yo; brain damage; chronic brain disease (AD) |
| |
Major causes of Delirium |
Hypoxia to brain; Depleted Na+ levels; Anticholinergic drugs; Infections (UTIs, etc) |
| |
Normal Aging |
Slight decrease of all memory -- short-term memory should not continually decrease while past (LT) memory stays intact |
| |
Criteria for Delirium |
Disturbance of consciousness: reduced awareness of environment, ability to focus, sustain, and/or shift attention |
| |
Findings on EEG |
Diffuse slowing @ resting state (Delirium = theta/beta waves in resting state; Normal = alpha waves) NOT DIAGNOSTIC! |
| |
Generic Etioligies of Delirium |
Systemic conditions, Endocrinopathies, Nutritional deficiencies, Intoxication, Withdrawal syn, Infections, Intracranial disorder, Focal cerebral lesions, etc |
| |
Dementia |
Persistend deficits causes intellectual impairment |
| |
Required Lab Tests for Dementia ("Medical Work-up") |
Brain scan (only to R/O tumor, stroke, etc), TSH levels, possible depression (Dx), CBC, serum levels, including vitamin B12 |
| |
Risk Factors for Dementia |
>65yo, Female gender, Head trauma, CV health decrease, Depression, ApoE4 |
| |
Earliest Finding of Dementia |
Short term memory defect, while long term memory intact w/ details |
| |
3 genes identified to cause Early Onset AD |
Amyloid protein, APP (on Chr 21), and Precinillin 1&2 (deal w/ metabolism of amyloid protein) |
| |
Frontotemporal dementia |
Predominated w/ tangles; decrease activity in frontal areas; personality changes may occur |
| |
Alzheimer's Disease (AD) |
More plaques present; decrease activity in temporal areas |
| |
Best Test for AD/Dementia |
Ask family member of an important RECENT event - then ask patient detailed questions; ~90% correct = normal; ~50% correct = AD/Dementia |
| |
Diagnosis of Probably AD |
Dementia present; Onset b/w 40-90yo; Deficits in 2 or more cognitive areas; Pregression of deficits > 6mo; Consciousness undisturbed |
| |
Neuropathology of AD |
Neurofibrillary Tangles = intracellular; Amyloid Plaques = extracellular |
| |
Stage 1 of AD |
Patient doesn't talk as much; Short-term memory defective |
| |
Stage 2 of AD |
Fluent aphasia; Memory severely impaired; Structural scan shows Temporal-parietal atrophy |
| |
Stage 3 of AD |
Intellectual function severely impaired; Mutism; Incontinence; Structural scan shows Diffuse atrophy |
| |
Psychiatric Symptoms often seen w/ AD |
Depression; Anxiety/Agitation; Psychotic symptoms; Sleeping disorders; Bipolar disorder; Paranoia |
| |
Amnesia |
Impairment in ability to learn new information despite normal attention |
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