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Delirium vs. Dementia

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Topic updated on 05/03/14 10:22am

Delirium
  • Acute onset change of consciousness with waxing and waning 
    • ↓ attention span
    • ↓ level of arousal
  • Characterized by
    • acute changes in mental status
    • disorganized thinking
    • hallucinations (often visual)
    • illusions
    • misperceptions
    • disturbance in sleep-wake cycle
    • cognitive dysfunction
    • abnormal EEG
  • Most common psychiatric illness on medical and surgical floors
    • may be caused by drugs with anticholinergic effects
    • other causes include CNS disease, infection, trauma, withdrawal, substance abuse
    • often reversible
Dementia
  • Gradual loss in cognition
    • NO CHANGE in level of consciousness
    • memory loss is present
  • Characterized by
    • memory deficits
    • aphasia
    • apraxia
    • agnosia
    • loss of abstract thought
    • behavioral/personality changes
    • impaired judgment
    • no loss of alertness
    • ↑ incidence with age
    • normal EEG
  • Caused by
    • Alzheimer's disease
    • thrombosis/hemorrhage
      • can have acute onset / step-wise progression
    • HIV
    • Pick's disease (Fronto-temporal dementia)
    • Lewy-bodies (Parkinson's dementia)
    • substance abuse (neurotoxicity)
    • CJD
  • Depression may present as dementia in elderly patients
    • known as pseudodementia


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Qbank (1 Questions)

TAG
0) (M1.PY.28) A 78-year-old male has been hospitalized for the past 3 days after undergoing a revision left total hip replacement. Over the past several hours, the nursing staff reports that the patient has exhibited fluctuating periods of intermittent drowsiness and confusion where he has been speaking to nonexistent visitors in his hospital room. The patient's daughter is present at bedside and reports that the patient lives alone and successfully manages his own affairs without assistance. Which of the following is most likely true of this patient's current condition? Topic Review Topic

1. Anticholinergic medications may alleviate his symptoms
2. Beta-amyloid plaques and neurofibrillary tangles are pathologic findings associated with this condition
3. Short-term memory is often impaired, with sparing of remote memory
4. The condition is typically irreversible, representing a common complication of aging
5. Possible etiologies include infection, trauma, or polypharmacy

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