Term
| if mental status change is just part of an underlying condition it is called- |
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Definition
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Term
| in _ ppl illness presenty atypically as AMS |
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Definition
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Term
| some sy mptoms of cognitive funct-4 |
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Definition
lethargic
disordered thinking
getting lost
confusion |
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Term
which mental status test mainly does orientation and recall?
is it used a lot or rare? |
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Definition
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Term
| which test is more sensitive |
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Definition
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Term
| whcih mental status test is for ppl with higher educaiton |
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Definition
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Term
| which m ental status test is more for concentration, problem solving? |
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Definition
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Term
| elderly are often wrongly diagnosed as dementia, what are the 3 probs with this? |
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Definition
1) failure to dx reversible illness
2) fail to correct drug induced
3) inappropiate anti dememntia meds |
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Term
| the mental status tests cant tell you? |
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Definition
specificity (the WHY)
reversible/irreversible |
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Term
| reversible cognitive impairments-3 |
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Definition
delirum
psuedo-dementia depression
drug induced |
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Term
| irreverisble cognition impairments-2 |
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Definition
dementia
mild cog impairment (MCI) |
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Term
|
Definition
alzheimers
frontal-temproal
pick's disease |
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Term
| sub cortical dementias- 5 |
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Definition
parkinson's
huntington's
normal hydroceph
progressive palsy
AIDS |
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Term
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Definition
lewy bodies
vascular impairment |
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Term
| cortical is which part of the brian? |
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Definition
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Term
| dementia in the cortical (cerebral cortex) result in what deificts-5 |
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Definition
amnesia
executive function
apraxia
aphasia
agnosia |
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Term
| loss of acquisisiton of learning and storage (memory)- |
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Definition
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Term
| loss of skilled acts or use tools- |
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Definition
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Term
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Definition
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Term
| loss of ability to recognize people/objects |
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Definition
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Term
sub cortical is what part of the brain?
what is not affected in this region?-3 |
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Definition
deep structures
high level thinking, memory, language |
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Term
| what deficits are present in sub coritcla dementia-6 |
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Definition
motor (tremor, shuffling)
voice
processing
bowel
autonomic (hypotenion, balance) and behavior |
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Term
| some determinaitons of reversible vs irreverible-4 |
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Definition
onset
family history
medications
other tramua |
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Term
| go thru physical assessment on pg 4 |
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Definition
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|
Term
| CBC can show what disorders are causin the mental change-3 |
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Definition
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|
Term
| serum chemistries reveal what could causes the mentla change-3 |
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Definition
| electrolytes, glucose, hept/renal impair |
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Term
| drug/metal conc can reveal what caused the mental disorder-3 |
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Definition
wilsons
intoxication
dehydration |
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Term
| 02 sats reveal what can cause emntal disorder |
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Definition
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|
Term
| what tests can be used to show what disorders can cause mental disorders-3 |
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Definition
thyroid
EEG (seizure)
ECG (cardiac) |
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Term
| primary drug induced cognitive impairment (DICI) |
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Definition
| drug's MOA directly caused impairment |
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Term
|
Definition
enhance primary DICI drugs
inappropiate use/dose leads to deterioration of mental illness |
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|
Term
what are the primary offenders of DICI-5
(look on lside 6 for a quick look ebfore the test) |
|
Definition
anticholinergics
benzo
antidep
NSAIDS
antibiotics |
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|
Term
| the risk of dementia from drugs increase when # of drugs increases to? |
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Definition
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Term
| *withdrawal from drug cna cause physilogic mental distubrances or just exacerbation of udnerlying disease. the underlying disease is more common! |
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Definition
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|
Term
| what 2 med classes are most assoc with adverse drug withdrawal events |
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Definition
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Term
| *psuedo-dementia depression ppl perform poorly on cognition and memory tests, but tis not dementia |
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Definition
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Term
| any time mental tests are done, mood status shoudl be evaluated to prevent mis dx |
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Definition
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Term
| what is an example of disease presentation |
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Definition
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|
Term
symptoms of delirium include _ or _
PLUS-3 |
|
Definition
altered consciouness or disorganized think
inattention, acute cange in AMS, fluctuating |
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|
Term
| deliruim can be either hyper or hypo active, so the best sign to dx delrium is- |
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Definition
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|
Term
more delerium on admission or during stay?
more in gen med or ICU |
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Definition
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|
Term
| delirum can decline an underlying mental problem |
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Definition
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|
Term
| delirium pts can cause death or readmission in 30 days post acute |
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Definition
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|
Term
| older pts hypothesis of delirium is _ deficiency nad _ increase |
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Definition
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|
Term
| what things contirbute to delerium-2 |
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Definition
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|
Term
| aytical disease presentions-5 |
|
Definition
imrporper blaance
sudden incontinence
lethergic
worseing cognition
sensory disturbance |
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|
Term
dementia and delirium
which is illnes and which is presentation? |
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Definition
|
|
Term
| what is the test for delirium? |
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Definition
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|
Term
| risk factors for delirium-6 |
|
Definition
old age
ICU
venitalted
fraility (low abumin, low body weight, etc)
dementia
polypharmacy |
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|
Term
the biggest cause fr delirium?
what are 3 others |
|
Definition
infection
pain, drugs, electrolyes |
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Term
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Definition
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Term
step 2 of tx delirium
ex-3
what is not the best to use? |
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Definition
mamange symptoms
temp, noise, reassuring presence
physical restaints (includes IVs, catheters, etc) |
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Term
| pharmacologic tx fro delisium |
|
Definition
d/c any causing meds
treat agitation
antipsychotics (only prn)
benzos |
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Term
| what is best to use for agitation? |
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Definition
| haloperidol .5 mg PO (can do buccal or injectabel too!) |
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Term
|
Definition
| alcohl withdrawal delrium |
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|
Term
| avoid cocktails of what meds in delirium |
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Definition
| lorazapm + halo + benadryl |
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Term
| common pitfalls with tx of delirium-2 |
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Definition
exessive dosing
inappropiate frequency |
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