Psychiatry: Cognitive Problems (Organic Psychiatric Disorder)

4098 Define delirium. How does it differ from conditions such as dementia?

4099 DDx for pt's presenting with delirium (acute confusion).

4100 Give a DDx for dementia.

Although the cause of alzheimer's DS (AD) is still not known, a great deal is now understood about the molecular pathology of AD. The pathological hallmarks are the deposition of β..... in a..... plaques in the cortex and formation of t..... containing intracellular n..... tangles. These protein aggregates damage synapses and ultimately lead to neuronal death.

4106 Multi-infarct dementia - multiple large infarcts, once they reach a certain volume and affect a large enough number of individual brain regions, will exhaust the brain's c..... mechanisms and lead to dementia. However, small infarcts in strategic areas such as the b..... g..... and t..... can also lead to dementia with only a small volume of brain having been infarcted. Most of these small infarcts - that is, <1.5 cm in size (l..... infarction) - are caused by a...... of the small irrigating superficial and deep penetrating arteries and arterioles. The underlying cause is thought to be secondary to ..... The basal ganglia, thalamus, pons, internal capsule, and deep white matter areas are maximally affected.

4107 Distinguish cortical & sub-cortical dementias & give examples of each.

4108 Describe investigations used to confirm dementia & look for treatable causes.

4109 Outline the Mx of pt's with dementia.

4110 Outline the MOA & role in Rx of drugs developed to treat the cognitive defect in AD.

4102 Seizures are divided by clinical pattern into two main groups – partial seizures & generalized seizures.

A partial (f.....) seizure is caused by electrical d..... restricted to a limited part of the cortex of ..... cerebral hemisphere. Partial seizures are further sub-divided according to whether or not there is loss of a.....:
– simple partial seizures – without loss of a....., e.g. one limb jerking (a Jacksonian seizure).
– complex partial seizures – with loss of a....., e.g. a temporal lobe seizure.

In generalized seizures, there is simultaneous involvement of both h....., always associated with loss of c..... or a.....

4103 Outline the psychiatric manifestations of epilepsy.