Delerium and Dementia in the elderly
Help!
|
|
||||
|---|---|---|---|---|---|
| Impoverished thinking is associated with | Dementia. Delirium manifests more disorganized thinking
🗑
|
||||
| difficulty finding words (impoverished thinking) is associated with | Dimentia. Delirium is associated with incoherent, hesitant, slow or rapid speech
🗑
|
||||
| Dementia definition | chronic deterioration of mental function sufficiently severe to interfere wtih daily living. Key features: 1)gradually progressing coursre (usually months to years) 2) No disorder of alertness
🗑
|
||||
| Risk Factors for dementia | age, fam hx, genetic mutations (alzheimer's), head trauma, hormone replacement therapy, CVD risk factors (vascular dementia), Low education levels
🗑
|
||||
| Protective factors against dementia | lesiure activities, aerobic and strength training, educational attainment, reducing CVD risk factors, head trauma protection
🗑
|
||||
| Potentially reversible or arrestable conditions associated with dementia (very unlikely to be reversible!) | Hypothyroidism, Vitamin B12 Deficiency,Neurosyphyllis,Subdural Hematoma,Vascular diseases (Multi-infarct ,Binswanger’s),Space-occupying lesions,Normal pressure hydrocephalusDepression (“pseudodementia” or depressive pseudodementia)
🗑
|
||||
| Progressive degenerative diseases causing dementia | Alzheimer’s DiseaseDementia of the Lewy Body TypeParkinson’s Disease DementiaFrontotemporal Dementia (Pick’s Disease)Huntington’s DiseaseCreutzfeldt-Jakob DiseaseAIDS Dementia
🗑
|
||||
| No. 1 degenerative disease causing dementia | Alzheimers
🗑
|
||||
| 25% of parkinson's patients will develop | dementia
🗑
|
||||
| Reversible Causes of Dementia Pneumonic | Drugs, Emotional disorders, Metabolic or endocrine disorders, Eye and ear dysfunctions, environmental, Nutritional deficiencies, Tumor and trauma, Infections, Atherosclerotic complications and alcohol
🗑
|
||||
| Drugs to be on the look out for with elderly and may be a reversible cause of dementia | Anticholinergics
🗑
|
||||
| Nutritional deficiencies that may be reversible causes of dementia | Vit B12, Folate
🗑
|
||||
| Symptoms tend to progress rapidly in: dementia or pseudodementia? | Pseudodementia and patient is very aware and bothered by the cognitive loss.
🗑
|
||||
| Near miss answers are uncommon in | depressed people (won't likely try).
🗑
|
||||
| Primary degenerative dementia (PDD) | another name for alzheimer's dz
🗑
|
||||
| CT and MRI in alzheimer's | not diagnostic
🗑
|
||||
| Brain biopsy in Alzheimer's shows | neurofibrillary tangles and neurtic plaques
🗑
|
||||
| Diagnosing Alzheimer's | this is a clinical diagnosis, and a diagnosis of exclusion. Multiple cognitive deficits manifested by memory impairment and at least 1 of the following: aphasia, apraxia, agnosia, disturbances in executive fxn. Impairment in social or occupational fxn
🗑
|
||||
| Alzheimer facts | generally presents in the 7th-8th decade, mean survival is 8-10 years
🗑
|
||||
| Mild Alzheimers | sx subtle and often undetected, decline of short-term memory
🗑
|
||||
| Moderate Alzheimers | Language abilities and ability to think abstractly and exercise judgement impairedDecline of visual and spatial skills
🗑
|
||||
| Severe Alzheimers | loss of long term memory, problem sleeping, weak unable to walk or talk, incontinent, completely dependent on the caregiver
🗑
|
||||
| Vascular dementia facts | M>F, >60, Stepwise time course of deficits, hx of htn, tia, stroke, focal neuro sx are common
🗑
|
||||
| Primary Degenerative Dementia Facts | F>M, >75, gradually progressive time course of deficits, hx of htn, stroke, tia, focal neuro sx are less common
🗑
|
||||
| Gait disturbance, incontinence and dementia is a triad seen in | normal pressure hydrocephalus
🗑
|
||||
| Main cause of Amnestic Syndromes | Thiamine deficiency, trauma or anoxia
🗑
|
||||
| Benign senescent forgetfulness | not really a dementia. person remembers what they forgot later.
🗑
|
||||
| Hx for the dementia patient | list drugs, cv and neuro hx, characterize sx (nature of the deficit, onset and RATE or progression, associated psych sx: depression, anxiety, agitation, paranoia, psychotic features), assess social situation, wandering, incontinence, endangering behavior
🗑
|
||||
| Assessing the social situation of the dementia patient | living arrangements, social supports, basic and instrumental ADLs
🗑
|
||||
| PE of the dementia patient | BP, CV exam, Neurologic, mental status exam: formal assessment is important, evaluate: memory, orienatation, intellectual fxn, judgment, affect, Folstein MMSE, clock drawing, fact test
🗑
|
||||
| Diagnostic studies in dementia pt | Blood studies: cbc, chem7, cal + phos, LFTs, Thyroid fxn, Vit B12 & folate, RPR (for latent syphilis) , ?ESR, ?HIV. Radiologic: CT or MRI, Other studies: neurophysiological testing
🗑
|
||||
| FACT test | Fruits, animals, colors and towns. Pt should be able to name at least 10 of each.
🗑
|
||||
| ___ is a test for latent syphillis | Rapid plasma reagin (RPR)
🗑
|
||||
| Drug therapy for dementia | cholinesterase inhibitors (for mild to moderate: slows down decline by months, not a dramatic difference that can be seen immediately), NMDA antagonist (moderate to severe)
🗑
|
||||
| Delirium and prevention | Delirium is often preventable. Dementia is only rarely preventable.
🗑
|
Review the information in the table. When you are ready to quiz yourself you can hide individual columns or the entire table. Then you can click on the empty cells to reveal the answer. Try to recall what will be displayed before clicking the empty cell.
To hide a column, click on the column name.
To hide the entire table, click on the "Hide All" button.
You may also shuffle the rows of the table by clicking on the "Shuffle" button.
Or sort by any of the columns using the down arrow next to any column heading.
If you know all the data on any row, you can temporarily remove it by tapping the trash can to the right of the row.
To hide a column, click on the column name.
To hide the entire table, click on the "Hide All" button.
You may also shuffle the rows of the table by clicking on the "Shuffle" button.
Or sort by any of the columns using the down arrow next to any column heading.
If you know all the data on any row, you can temporarily remove it by tapping the trash can to the right of the row.
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
Created by:
ltm12