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What is Global cerebral dysfunction characterised by alteration in cognitive function and consciousness is known as and explain in detail?
Ans. c (Delirium) (Ref. Kaplan & Sadock's Synopsis of Psychiatry, 10th ed., p. 325. Table 10.2-5)Global cerebral dysfunction characterised by alteration in cognitive function and consciousness is known as delirium.# Delirium is Characterized by disorganized thinking, hallucinations (often visual), illusions, misperceptions, disturbance in sleep- wake cycle, cognitive dysfunction.# Usually 2deg to other illness (e.g., CNS disease, infection, trauma, substance abuse/withdrawal, metabolic/electrolyte disturbances, hemorrhage, urinary/fecal retention).# Most common presentation of altered mental status in inpatient setting. Abnormal EEG.# Treatment:Identify and address underlying cause. Optimize brain condition (02, hydration,# pain, etc). Antipsychotics (mainly haloperidol).Delirum versus DementiaCharacteristicsDeliriumDementiaHistoryAcute, identifiable dateChronic, cannot be datedOnsetRapidInsidiousDurationDays to weeksMonths to yearsCourseFluctuatingChronically progressiveLevel of consciousnessFluctuatingNormalOrientationImpaired periodicallyDisorientation to personMemoryRecent memory markedly impairedRemote memories seen as recentPerceptionVisual hallucinationsHallucinations less commonSleepDisrupted sleep-wake cycleLess sleep disruptionReversibilityReversibleMostly irreversiblePhysiologic changesProminentMinimalAttention spanVery shortNot reduced PsychosisA distorted perception of reality (psychosis) characterized by delusions, hallucinations, and/ or disorganized thinking. Psychosis can occur in patients with medical illness, psychiatric illness, or both.HallucinationsPerceptions in the absence of external stimuli (e.g., seeing a light that is not actually present).DelusionsUnique, false beliefs about oneself or others that persist despite the facts (e.g., thinking aliens are communicating with you)Somatoform disordersSomatization disorder# Set of eight more symptoms (four pain, two gastrointestinal, one sexual, one pseudoneurologic)# Onset before age 30# Symptoms usually occur over period of years# More common in women than in men (20 to 1)Conversion disorder# One or more symtoms# Altering of physical functioning, suggesting physical disorder# Usually skeletal, muscular, sensory, or some peripheral non-autonomic system, e.g., paralysis of the hand, loss of sight# Loss of functioning is real and unfeigned# Loss for la belle indifferenceHypochondriasis# Unrealistic interpretation of physical sign as abnormal# Preoccupation with illness or fear of illness when none present# Preoccupation persists in spite of reassurance# At least 6 months duration# Treat by simple palliative care and fostering relationshipSomatoform pain disorder# Severe, prolonged pain with no cause found# Pain disrupts day-to-day life# Look for secondary gainBody dysmorphic disorder# Preoccupation with unrealistic negative evaluation of personal attractiveness# Sees self as ugly or horrific when normal in appearance# Preoccupation disrupts day-to-day life# May seek multipe plastic surgeries or other extreme interventions