Podcast
Questions and Answers
What is the primary neurotransmitter affected in delirium pathophysiology?
What is the primary neurotransmitter affected in delirium pathophysiology?
What is a characteristic of delirium in terms of onset and course?
What is a characteristic of delirium in terms of onset and course?
Which of the following is NOT a predisposing factor for delirium?
Which of the following is NOT a predisposing factor for delirium?
What is the primary cognitive deficit seen in delirium?
What is the primary cognitive deficit seen in delirium?
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Which neurotransmitter imbalance is implicated in delirium pathophysiology?
Which neurotransmitter imbalance is implicated in delirium pathophysiology?
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What is the primary step in the diagnosis of delirium?
What is the primary step in the diagnosis of delirium?
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Which region of the brain is responsible for engaging attention in the pathophysiology of delirium?
Which region of the brain is responsible for engaging attention in the pathophysiology of delirium?
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Which hemisphere of the brain is dominant for attention, according to evidence?
Which hemisphere of the brain is dominant for attention, according to evidence?
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What is a possible explanation for the pathophysiology of delirium?
What is a possible explanation for the pathophysiology of delirium?
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Which cognitive function is impaired in delirium?
Which cognitive function is impaired in delirium?
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What is a common underlying cause of delirium?
What is a common underlying cause of delirium?
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What is the role of the Thalamic nuclei in the pathophysiology of delirium?
What is the role of the Thalamic nuclei in the pathophysiology of delirium?
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What is the primary characteristic of a patient in a vegetative state?
What is the primary characteristic of a patient in a vegetative state?
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Which of the following is a characteristic of delirium?
Which of the following is a characteristic of delirium?
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What is the primary difference between a stupor and a coma?
What is the primary difference between a stupor and a coma?
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Which of the following is a characteristic of psychogenic unresponsiveness?
Which of the following is a characteristic of psychogenic unresponsiveness?
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What is the primary characteristic of a minimally conscious state?
What is the primary characteristic of a minimally conscious state?
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Which of the following is a characteristic of akinetic mutism?
Which of the following is a characteristic of akinetic mutism?
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What is the primary characteristic of a locked-in syndrome?
What is the primary characteristic of a locked-in syndrome?
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Which of the following is NOT a characteristic of delirium?
Which of the following is NOT a characteristic of delirium?
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Study Notes
Delirium
- Differential diagnosis: hypoglycemia, hypoxia, and other metabolic changes affecting acetylcholine-mediated functions
- Involvement of other neurotransmitters: dopamine, serotonin, norepinephrine, GABA, glutamine, opiates, and histamine
Clinical Characteristics
- Acute onset of mental status change with fluctuating course
- Attentional deficits, confusion, disorganized thinking, and altered level of consciousness
- Perceptual disturbances, disorientation, memory impairment, and other cognitive deficits
- Behavioral and emotional abnormalities, and sleep/wake cycle disturbances
- Alerted psychomotor activity
Diagnosis
- Two-step process: recognition of delirium and defining the cause from potential diagnoses
- General history, physical examination, and laboratory assessment
Predisposing and Precipitating Factors
- Elderly, dementia, fluid and electrolytes disturbances, dehydration, fever, drug abuse, alcohol, fractures, male gender, and depression
- Specific surgery
Pathophysiology
- Widely distributed neurological dysfunction
- Dysfunction of anterior cingulate cortex, bilateral or right frontal cortex, temporoparietal junction region, thalamus, and upper brainstem structures
- Thalamic nuclei and right hemisphere dominance for attention
- Alterations in neurotransmitters, particularly cholinergic-dophaminergic imbalance
Impairment of Consciousness
- Drowsiness: mild-to-moderate decreased level of alertness and interest in the environment
- Stupor: decreased level of alertness, requiring vigorous stimuli to be aroused
- Coma: absent response to noxious stimuli, closed eyes, and no perception of external stimuli
- Persistent Vegetative State: arousal present, including sleep-awake cycle, but no awareness
- Minimally Conscious State: makes eye contact, orients, and tracks stimuli, with abulic and emotionless behavior
- Delirium: rapidly fluctuating change in cognition, agitation, and disorientation
- Akinetic Mutism: alert appearance, lack of spontaneous motor activity, and lack of recognition of content
- Locked-in Syndrome: paralysis of extremities and cranial nerves, with preserved sensation and consciousness
- Psychogenic Unresponsiveness: forced gaze, non-epileptic abnormal movements, and characteristic responses to specific tests
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Description
This quiz assesses your knowledge of neurotransmitters and their effects on mental status, cognitive function, and behavioral changes. It covers acetylcholine, dopamine, serotonin, and other neurotransmitters, as well as their involvement in various neurological symptoms.
