3MB Psychiatry: Delirium and Memory Problems
This flashcard set identifies delirium as the most common mental health problem in hospitalized patients over 65, outlines its core features including cognitive, psychomotor, emotional, and sleep-wake disturbances, and describes clinical manifestations of impaired consciousness ranging from clouding to coma.
What is the most common mental health problem in hospitalised patients above the age of 65?
Delirium
Key Terms
What is the most common mental health problem in hospitalised patients above the age of 65?
Delirium
What are the main features of delirium?
Impaired consciousness
Disturbed cognition
Psychomotor disturbance
Emotional disturbance
Disturbed sleep-wake cycle
What might be seen clinically if a patient has impaired consciousness?
Clouding
Drowsiness
Stupor
Coma
What might be seen clinically if a patient has disturbed cognition?
Disorientated for time and place
Impaired memory and attention
Impaired thinking
Perceptual disturbance (hallucinations, delusions)
What are the 2 main psychomotor variants of delirium?
Hypoactive
Hyperactive
Can get mixed picture
What might be seen clinically if a patient has hypoactive delirium?
Confusion
Sedation
Depression (misdiagnosis)
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| Term | Definition |
|---|---|
What is the most common mental health problem in hospitalised patients above the age of 65? | Delirium |
What are the main features of delirium? | Impaired consciousness Disturbed cognition Psychomotor disturbance Emotional disturbance Disturbed sleep-wake cycle |
What might be seen clinically if a patient has impaired consciousness? | Clouding |
What might be seen clinically if a patient has disturbed cognition? | Disorientated for time and place |
What are the 2 main psychomotor variants of delirium? | Hypoactive |
What might be seen clinically if a patient has hypoactive delirium? |
|
What might be seen clinically if a patient has hyperactive delirium? | Agitation |
Describe the course of delirium | Fluctuating, transient course |
What drugs can typically cause delirium? | Anticholinergic Anticonvulsant Parkinson drugs Steroids Opiates Alcohol Illicit drugs |
Withdrawal from what substances can typically cause delirium? | Alcohol |
List some metabolic abnormalities that can typically cause delirium | Hypoxia |
No identifiable cause excludes a diagnosis of delirium. True/False? | False |
List the main risk factors for delirium | Elderly Existing dementia Sensory deficits Perioperative Immobility Social isolation, stress |
List the main formal cognitive tests that should be carried out for delirium |
|
Sedating drugs can worsen delirium. True/False? | True |
How is delirium due to alcohol withdrawal managed with medication? | Benzodiazepine |
What is the general pharmacological management of delirium? | Antipsychotic - haloperidol |
Who typically gets hyperactive delirium? | Elderly with recent injury e.g. hip fracture |
What time of day is delirium typically worse? | Night |
What is the shortest type of memory? | Sensory memory (less than 1s) |
List the 2 main domains of long-term memory and their function | Explicit memory (conscious) Implicit memory (unconscious) |
Procedural memory is part of what - implicit or explicit memory? What kind of memory does it enable? | Implicit memory Remembering skills and doing tasks |
Declarative memory is part of what - implicit or explicit memory? What kind of memory does it enable? | Explicit memory Remembering facts and events |
What are the 2 main domains of declarative memory and their memory functions? | Episodic memory (events, experiences) Semantic memory (facts, concepts) |
What is anterograde amnesia? | Difficulty acquiring new material and remembering events since onset of illness/injury |
What is retrograde amnesia? | Difficulty remembering information prior to onset of illness/injury |
List some typical reports of memory problems | Forgetting a message Losing track of conversation Forgetting to do things Inability to navigate to familiar places Misplacing things Struggling with names |
What are the main domains assessed in cognitive screening? | Memory Attention, concentration Executive function Visuo-spatial function Language |