Cognitive Disorders and Delirium Quiz

Podcast

Play an AI-generated podcast conversation about this lesson

Questions and Answers

What is a primary characteristic of senile dementia?

Acute onset

Fluctuating course

Permanent impairment (correct)

Reversible symptoms

Which of the following is NOT a psychological feature of senile dementia?

Confabulations

Hallucinations

Mood swings

Euphoria (correct)

How does the onset of delirium differ from that of dementia?

Delirium has a gradual onset

Delirium is often persistent

Dementia has an acute onset

Delirium has an acute onset (correct)

Which of the following physical features is associated with senile dementia?

Fragile bones Signup and view all the answers

What symptom is characteristic of the memory loss in senile dementia?

Anterograde amnesia occurs first Signup and view all the answers

What term is now globally used to refer to cognitive disorders traditionally known as organic mental syndrome?

Neurocognitive Disorders Signup and view all the answers

Which of the following is not a recognized cause of cognitive impairment disorders in the 'MEND A MIND' mnemonic?

Emotional disorder Signup and view all the answers

What characterizes delirium according to the definition provided?

Clouding of consciousness Signup and view all the answers

Which age group shows a significant occurrence of delirium upon hospital admission?

Patients over 65 Signup and view all the answers

What is the usual outcome once the cause of delirium is detected and treated?

Full recovery Signup and view all the answers

Which of the following is a type of delirium?

Substance-induced delirium Signup and view all the answers

Which of the following conditions is identified as a potential cause of delirium?

Infections Signup and view all the answers

Which substance is specifically mentioned as a cause of drug-induced delirium?

Opioids Signup and view all the answers

Which of the following symptoms is NOT typically associated with delirium?

Stable level of alertness Signup and view all the answers

Which investigation is least likely to be performed for a diagnosis of delirium?

Skin Biopsy Signup and view all the answers

Which characteristic is a hallmark of dementia compared to delirium?

Impairment in social functioning Signup and view all the answers

What type of drugs are NOT listed as potentially relevant in the puerperium section?

Antidepressants Signup and view all the answers

Which mental state is described as being characterized by a stable level of awareness during early stages?

Dementia Signup and view all the answers

Which of the following metals is specifically mentioned in the content regarding potential health risks?

Lead Signup and view all the answers

What is a common symptom seen in patients experiencing delirium?

Visual hallucinations Signup and view all the answers

Which of the following is NOT a drug class listed under puerperium?

Antihistamines Signup and view all the answers

Which type of dementia is characterized by impairment due to blood flow issues in the brain?

Vascular Dementia Signup and view all the answers

What term is used to describe loss of memory of recent events, followed by loss of memory of past events?

Anterograde Amnesia Signup and view all the answers

Which clinical feature is more commonly associated with dementia?

Depression Signup and view all the answers

Which condition is NOT recognized as a type of dementia?

Mild Cognitive Impairment Signup and view all the answers

Which cause of dementia is associated with vitamin deficiencies?

Vitamin B12 deficiency Signup and view all the answers

Which term describes inappropriate sexual behavior often observed in dementia patients?

Lability of mood Signup and view all the answers

What distinguishes Amnestic Syndrome from other cognitive impairment disorders?

It involves short-term and long-term memory impairment without affecting consciousness Signup and view all the answers

Which cognitive symptom is commonly seen in dementia related to poor judgment?

Inappropriate decisions Signup and view all the answers

What is a common symptom of opioid use?

Lacrimation Signup and view all the answers

What is the primary cause of alcoholism mentioned?

Peer group influence Signup and view all the answers

Which of the following is NOT a method for diagnosing substance abuse?

Medical imaging Signup and view all the answers

What is a characteristic effect of consuming large doses of alcohol?

Muscular in-coordination Signup and view all the answers

What is a typical symptom of pathological intoxication?

Loss of self-control Signup and view all the answers

What is a recommended management step for a person experiencing alcohol intoxication?

Inducing vomiting with salty water Signup and view all the answers

What does dipsomania refer to?

Periodic excessive drinking Signup and view all the answers

Which factor does NOT contribute to causes of alcoholism?

Strong family support Signup and view all the answers

What is a significant vitamin deficiency associated with Alcohol Amnesic Disorder?

Vitamin B1 (Thiamine) Signup and view all the answers

Which of the following is NOT a characteristic mental symptom of Alcohol Amnesic Disorder?

Cravings for alcohol Signup and view all the answers

What physical symptom may result from damage to peripheral nerves in individuals with Alcohol Amnesic Disorder?

Pain and tenderness in the calves Signup and view all the answers

What is a common cause of Alcohol Amnesic Disorder?

Chronic alcohol use Signup and view all the answers

What management is usually necessary for chronic alcoholism?

Hospitalization Signup and view all the answers

Which of the following symptoms is NOT associated with chronic alcoholism?

Increased personal hygiene Signup and view all the answers

Which symptom indicates poor insight into one's condition in Alcohol Amnesic Disorder?

Confabulation Signup and view all the answers

What is a typical characteristic of the onset of Alcohol Amnesic Disorder?

Gradual onset Signup and view all the answers

Study Notes

Neurocognitive Disorders

Neurocognitive disorders is a new global term that encompasses delirium and dementia diagnoses (DSM-5, 2013). Previously, these were called organic mental syndrome and disorder.

Causes of Cognitive Impairment Disorders

Cognitive psychotic conditions have various etiologies.
A mnemonic device, "MEND A MIND", helps recall possible causes:
M - Metabolic disorder
E - Electrical disorder
N - Neoplastic disease
D - Degeneration
A - Arterial disease
M - Mechanical disease
I - Infectious disease
N - Nutritional disease
D - Drug toxicity

Delirium

Definition: An acute organic mental syndrome marked by clouding of consciousness, disorientation, memory impairment, and decreased concentration. It is reversible.
Prevalence: Up to 15% of patients over 65 are delirious upon hospital admission.
Risk factors: Increasing age, underlying dementia, and physical illness.
Outcome: Typically full recovery.
Onset: Sudden and tends to resolve rapidly when the cause is identified and treated.
Types: General medical condition, substance-induced delirium (including substance intoxication and withdrawal), delirium due to multiple etiologies, delirium not otherwise specified.
Causes of Infections: Systemic infections like malaria, typhoid fever, pneumonia.
Causes of Drug Intoxication/Withdrawal: Alcohol, anxiolytics, opioids, CNS stimulants, cocaine, crack, amphetamines, marijuana
Causes of neurological disorders: Intracranial problems like meningitis, encephalitis, cerebral malaria; seizures; head trauma; Hypertensive encephalopathy.
Drugs (Post-operative/ Post-partum): Antibiotics, Antiparkinsonian, Anticholinergics/Antituberculosis, Anticonvulsants, Analgesics, Anti-inflammatory, Cardiac, Sedatives, Hypnotics.
Metals and Gases: Mercury, Lead, Arsenic, Carbon Monoxide.

Dementia

Definition: Characterized by the (usually) insidious (but sometimes acute) development of generalized brain dysfunction with multiple cognitive deficits. Impairment in social and/or occupational functioning results in a decline from the patient's previous level of functioning.
Awareness & Alertness: In early dementia, awareness & mental alertness is typically intact and stable in contrast to delirium's unstable alternating level of consciousness.
Memory Impairment (common): Ability to learn new information and recall previously learned information is impaired.
Types: Alzheimer's type, Vascular Dementia, HIV related, Head trauma related. Parkinson's disease related, Huntington's disease related, Rick's disease related, Creutzfeldt-Jakob Disease related, Other General Medical Conditions related, Substance-Induced Persisting Dementia, multiple etiology related, not otherwise specified
Causes (Partial): Alcohol-related, Alzheimer's Disease, Amyotrophic lateral sclerosis, Bromide poisoning, Chronic granulomatous meningitis (e.g., tuberculosis, fungal), Folic Acid deficiency, Head trauma, HIV, Huntington's chorea, Hypothyroidism, Multi-infarct Dementia, Multiple sclerosis, Neoplasms, Normal-pressure hydrocephalus, Postanoxic state, Progressive Supranuclear Palsy, Transmissible virus dementia (e.g., Jacob Creutzfeldt), Vitamin B12 deficiency.

Other Cognitive Impairment Disorders

Amnestic Syndrome: Cognitive impairment disorder where consciousness is not affected; short-term and long-term memory is impaired.
Organic Delusional Syndrome: Predominant delusion without change in consciousness, intellectual abilities, or mood.
Organic Hallucinations: Hallucinations without changes in consciousness, intellectual abilities, or mood, and without delusions.
Organic Mood Syndrome: Change in mental status with two of the symptoms for a manic or major depressive episode. No changes in consciousness or intellectual abilities, no hallucinations or delusions.
Organic Anxiety Syndrome: Characterized by active, recurrent panic attacks or generalized anxiety.
Organic Personality Syndrome: Major change in personality style, including emotional swings, decrease in impulse control.

Pre-Senile Dementia

Chronic organic mental condition causing intellectual and emotional impairment before the age of 65 due to organic cerebral changes.
Examples: Huntington's chorea (severe cerebral degeneration, genetic onset 30-50 years), Pick's disease (atrophy of the frontal lobe of cerebrum), Alzheimer's disease (premature degeneration of CNS).

Senile Dementia

Chronic organic mental illness due to degenerative brain changes resulting from old age (often age 65 and above). Characterized by permanent impairment symptoms and behavioral changes.

Clinical Features (Senile/Pre-senile Dementia)

Psychological Features: Feeling rejected, regression (behaving like a child), loss of memory/amnesia, overtalkative, delusions of persecution, regression to childhood.
Physical Features: Incontinence, general bodily weakness, loss of appetite, shuffling gait, blurred-incoherent speech, weight loss, blurred vision, deafness, wrinkled/ inelastic skin, loss of teeth, fragile bones, neglect of personal hygiene, epileptic fits, paranoid and hypochondriac delusions.
Physical Features (Developmental): Delayed developmental stages (sitting, standing, walking, talking), physical abnormalities (stigmata).

General Paralysis of the Insane (GPI)

Chronic form of syphilis affecting the CNS.
Progresses through stages (Primary, Secondary, Tertiary) over 5-75 years.

Clinical Features (GPI)

Symptoms are neurological and psychological, ranging from slow to quickly excitable symptoms.
Psychological Symptoms: Loss of memory, impaired judgment, disorientation, lack of initiative/concentration; grandeur delusions, nihilistic delusions, mood swings, credulousness.
Neurologic symptoms: Pupils small, unequal, irregular, do not react to light (Argyll Robertson); Tremors of lips, tongue, facial muscles – slurred indistinct speech. Tremors of hands, incoordination of movements; epileptic attacks. Ongoing deterioration leads to complete dementia, physical deterioration, and increase in appetite.

Parkinson's Disease (Paralysis Agitans)

Affects approximately 1 in 1000 of the general population and 1% of those over 70. Peak incidence is in the sixth decade of life.
Clinical syndrome: tremor, rigidity, and bradykinesia.
Associated conditions: neuroleptic drugs, Wilson's disease, cerebral anoxia, Shy-Drager syndrome
Clinical features often include Akinesia, Rigidity, Pill-rolling tremor, Postural abnormality, Shuffling gait, Difficulty in handwriting or walking. Depression, Anxiety, Bradyphrenia, Slow thinking, Slurred speech, Masklike face

Epilepsy

Brain disorder characterized by recurring excessive neuronal discharge. Manifested as transient episodes of motor, sensory or psychic dysfunction, with or without unconsciousness or convulsive movements. Marked changes are recorded in electrical brain activity.
Causes: Many causes remain unknown.
Constitutional: Genetic predisposition, endocrine disorders, age, body build
Predisposing: Intracranial infections, degenerative diseases, brain tumors, head injuries, metabolic disorders
Precipitants: Emotional stress, unknown causes, drugs, boredom, sensory stimulus, fatigue, crowd of people
Other/Specific: Sexual activity, excitement, strong emotions, fevers.
Types/Classifications: Generalized (grand-mal, petit-mal), Focal/Partial (psychomotor, Jacksonian).

Generalized Epilepsy (Grand-mal)

Characterized by 4 distinctive phases:
Aura/warning phase
Tonic phase (prolonged muscle contraction)
Clonic phase (muscle spasm and relaxation)
Coma phase (complete unconsciousness)

Epilepsy (Petit-mal)

Brief loss of consciousness, lasting 5-20 seconds.
Patient may appear lost/confused; stop activity; stare and blink.

Partial or Focal Epilepsy

In this type, consciousness may be retained while the abnormal discharge is localized in one region of the brain. Includes psychomotor seizures and Jacksonian seizure, among others.

Epileptic Dementia

Gradual mental decline and deterioration in later life, often in patients with severe early-onset epilepsy, whose condition hasn't responded to treatment.

Mental Retardation

Impairment in adaptive behavior due to low intelligence, learning disabilities, and slowed developmental process before the age of 18 years.
Onset: Manifests during developmental period before 18 years. If similar clinical picture occurs after age 18, it is considered dementia.
Genetic Factors: Abnormal genes responsible for physical or mental abnormalities that may be passed from parents.
Environmental Factors:
Prenatal life: Infections (rubella, congenital syphilis, mumps, meningitis) malnutrition, repeated exposure to radiation, chemical exposure (e.g., thalidomide, large doses of insulin or alcohol), threatened abortion.
During birth: Improper forceps delivery, difficult/prolonged labor, hemorrhage into brain tissue, placental abnormalities
Childhood/infancy: Malnutrition
Diagnosis: Based on physical outlook, mental development, school/occupational performance. IQ testing (Mental Age/Chronological Age x 100).
Levels: Mild, Moderate, Severe, Profound.

Substance (Drug and Alcohol) Abuse

Definition: Excessive intake of mind-altering agents that interfere with biological, physiological, and socio-cultural integrity. It includes taking drugs/alcohol other than prescribed dosage.
Examples of drugs: Marijuana, Cocaine, Herion, Mescaline, LSD, Amphetamines, Barbiturates, Morphine.
Causes: Hereditary factors, familiar factors, Anxiety, peer group influence, psychological problems, chronic physical illness, specific job types, rebellion, curiosity.
Characteristics of Substance Dependence: Compulsive/repeated use despite adverse effects, Chemical/physical dependence.
Other Characteristics: Craving, tolerance (need for larger doses to get same effect), addiction (physically/psychologically dependent on drug), and withdrawal syndrome.
Examples of Withdrawal Symptoms from Alcohol: Tremors of hands, nausea, vomiting, high blood pressure, tachycardia, sweating, headache, anxiety, insomnia, hallucinations, illusions, delusions, seizures, craving.
Examples of Withdrawal Symptoms from other drugs: Depression, fatigue, insomnia, disorientation (from amphetamines); depression, irritability, insomnia, severe craving (from cocaine); anger, frustration, lack of concentration, decreased appetite, craving (from marijuana).
Diagnosis: History from client, friends, or relatives; blood/urine screening; breathalyzer for alcohol detection.

Prevention of Drug and Alcohol Dependence

Education campaigns targeting youth and general public.
Legal measures like placing restrictions on drug sales, drug distribution, regulation of proper prescribing.

Alcoholic Psychoses

Pathological Intoxication: Acute excitement marked by violence, disorientation, and loss of self-control
Management of Intoxication: Induce vomiting, administer warm sweet drinks, encourage sleep.

Dipsomania

Characterized by periodic bouts of excessive alcohol consumption lasting 2-3 weeks. Person usually neglects work, hygiene, can accept any alcohol. The person is sober between bouts. Psychotherapies are used for treatment.

Delirium Tremens (Alcohol Withdrawal Delirium)

Psychiatric disorder characterized by signs and symptoms in chronic alcoholics within 72 hours of alcohol withdrawal (due to hospitalization, imprisonment, or other reasons).
Causes: Sudden withdrawal following prolonged consumption; existing physical illness
Symptoms: Tremors, nausea/vomiting, headache/insomnia, sweating, palpitation (increased heart rate), gastritis, furred tongue, high temperature, malaise, high blood pressure, seizures, confusion, disorientation, irritability, depression, anxiety, restlessness, illusions/hallucinations;

Korsakoff's Psychosis

Psychiatric disorder in alcoholism due to thiamine deficiency (vitamin B1); can lead to Wernicke's Encephalopathy.
Causes: Alcoholism, malabsorption syndrome, severe anorexia, upper gastrointestinal obstruction, prolonged intravenous feeding (with vitamin deficiencies), thyroid issues
Symptoms: Poor memory of recent events (anterograde amnesia), difficulty identifying family members (mistaking identity), episodes of confusion and disorientation, emotional liability, illusions, lack of insight. Physical Symptoms: Malnutrition, damage to peripheral nerves (pain & tenderness in calfs, weak feet muscles), sensory loss, eye palsies (nystagmus).

Chronic Alcoholism

Prolonged/habitual alcohol consumption leading to gradual mental and physical deterioration, including clinical manifestations like neglect of work, personal hygiene, memory issues, failure in judgment, irritability, childishness. Potential suicidal tendencies, cirrhosis of the liver, and tremors.

Management of Chronic Alcoholism

General: Hospitalization, prevent delirium tremens.
Specific: Nutritional care, tranquilizers, observation for suicide tendencies, attention to physical & personal hygiene, aversion therapy (antabuse), psychotherapy, counseling, support groups (e.g., AA), occupation/rehabilitation therapy.

Studying That Suits You

Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

Description

Test your knowledge on cognitive disorders, specifically focusing on senile dementia and delirium. This quiz covers characteristics, symptoms, causes, and definitions related to these conditions. Ideal for those studying psychology or healthcare-related fields.