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21 Cards in this Set
- Front
- Back
List the 4 key features of delirium.
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1. Disturbance of counciousness
2. Change in cognition/new perceptual distrubance 3. Develops over a short period of time- hours to days. 4. caused by medical condition, intoxication, medication |
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What is the characteristic appearance of EEG in delirium?
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slowing of the dominant posterior alpha rhythm and the appearance of abnormal slow-wave activity
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Mental Health Act 2007
Briefly explain sections 2, 3, 17 and 117. |
Section 2. 28 days assessment.
Section 3. up to 6 months treatment - renewable Section 17. 6 months residing in a specified address and/or receiving services - renewable. Section 17. Aftercare: social care is free to those discharged from S3 or on CTO |
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What is the characteristic appearance of EEG in delirium?
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slowing of the dominant posterior alpha rhythm and the appearance of abnormal slow-wave activity
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Broadly classify falls into 4 major categories?
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1. Accidental falls
2. Trips 3. Syncope (cardiogenic, neurogenic) 4. other drop attacks, including seizures |
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List causes od dizziness.
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Vestibular (central, peripheral, BPPV)
• Acute labyrinthitis • Uncompensated previous vestibular injury • Proprioceptive loss • Central vestibular / cerebrovascular • cardiovascular |
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List 3 categories of the history/mental state examination that often require greater attention than in younger people.
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1. Past Medical History
2. Social History 3. cognitive testing |
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3 sources of information (other than from the
patient) that aid the diagnostic process |
Caregiver/GP/family
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7 aspects of the social history relevant to older people
with mental disorders |
1. LIVING ARRANGEMENTS;
2.TYPICAL DAY; 3. PADLs; 4. IADLs; 5. MOBILITY 6. HEARING 7. EYESIGHT; 8. HOME CARE 9. DAY CARE 10. SOCIAL/FAMILY SUPPORT 11. FINANCES |
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3 tests of frontal lobe function used in bedside testing
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1. Verbal fluency (animals in 1 minute)
2. Set shifting (A1 B2 C3 etc) 3. Response Inhibition (Go/No go tasks) 4. Similarities 5. Judgement 6. Sequencing (AKA executive function) |
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2 techniques for introducing cognitive testing to
older people without upsetting or annoying them. |
‘I’d like to ask you some questions about your memory and concentration’
‘Some questions may seem very easy, but I ask everyone the same questions’ ‘Some questions are more difficult than others’ |
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list the features that make up the syndrome of dementia
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Amnesia – antero (inability to make new memory) and retrograde (memory loss)
Aphasia Apraxia – inability to replicate a learned motor action Agnosia Executive dysfunction – can not function well in social environment Full alertness (different than delirium) |
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Describe the common causes of dementia
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Alzheimer’s
Vascular dementia Lewy body dementia Head trauma HIV Parkinson’s / Huntington’s/MS Substance abuse |
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True or False
1. Dementia is a speeding up of the normal ageing process of the brain. 2. 5% >65 have dementia. 3. Up to 90% of demented patients will have behavioural problems. |
1. F Dementia is a pathological process.
2. T 5% of all people over 65 have dementia. The prevalance doubles with each 5 year age increase. 3. T |
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True or False:
4. Low dose Risperidone is a good choice for the pharmacological management of behavioural problems in dementia. 5. Benzodiazepines are a good class of drug for the management of behavioural problems of dementia. 6. CBT is of proven benefit in management of BPSD. 7. Behavioural techniques are used in BPSD. |
4. F Risperidone (and Olanzapine) are now contraindicated
in dementia except in special cases. 5. Bad question T if used in short-term F for long-term. 6. F 7. T |
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What is the prevalence of dementia over the ages of 65, 75 and 85?
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1 in 20 over age 65
1 in 10 over age 75 1 in 5 over age 85 |
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NON-DRUG TREATMENT for dementia?
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Explain diagnosis & prognosis
Promote function Social help Support groups Help carers |
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DRUG TREATMENT OF AD?
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• Anticholinesterases
• NMDA Receptor antagonists • Antidepressants • Neuroleptics |
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MENTAL TEST SCORE
(MTS/AMT) ? |
Age
Date of birth Year Hour of day Institution Count back from Address for recall Monarch First World War 202 people |
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Define Dementia.
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Global Impairment of
– Memory – Personality – Cognition – Executive function • In clear consciousness • Chronic and progressive |
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Differentiating AD, VaD
and LBD? |
• AD - gradual progressive course with steady global
deterioration • VaD - stepwise course with sudden deteriorations and sporadic decline in different functions. May be neurological signs and signs of arterial disease, and risk factors for vascular disease • LBD - marked fluctuation and early manifestations of psychiatric symptomatology (e.g. visual hallucinations). EPS may occur early on. Memory loss is sometimes not as prominent a feature as it is in AD |