10-22 L2 Dementia

Question 1

Dementia

Answer 1

• progressive intellectural deterioration
  
  • (sufficiently severe to interfere with social or occupational functions)
• not static but not necessarily untreatable or irreversible

Question 2

Name 5 causes of dementia

Answer 2

• Diabetes (recurrent hypoglycemia)
• stroks
• HIV or syphilis
• B13 deficiency (GI surgeries, pernicious anemia
• Depression (pseudo-dementia)
  
  • single most treatable dementia

Question 3

What are the 3 causes of peripheral neuropathy

Answer 3

• Diabetes
• Alcohol-related
• B12 deficiency (especially with myelopathy)

Question 4

Name the 6 causes of dementia

(DAMM-NC)

Answer 4

• Drug induced dementia
• Alcohol-related dementia
• Metabolic dementia
• Multi-infarct dementia
• Normal pressure hydrocephalus
• Chronic infections dementia

Question 5

Name two categories of drug induced dementia (and give 2 examples of each category)

Answer 5

• Anticholinergic medications
  
  • benzotropine (cognetin)
  • Trihexyphenidyl (artane)
• Anticholinergic action
  
  • Amitriptyline (Elavil)
  • Diphenhydramine (Benadryl)
• Other
  
  • benozdiazepines
  • narcotics
  • alcohol
  • many, many rare offenders

Question 6

Name 3 causes of metabolic dementia

Answer 6

• Hypothyroidism
• Diabetes mellitus
  
  • repeated episodes of hypoglycemia
  • risk fator for multi-infarct dementia
• B-12 deficiency
  
  • Gi surgery
  • Anemia

Question 7

What is seen with Alcohol-related dementia

Answer 7

• Wernickes encephalopathy
• Korsokoff dementia

Question 8

What are the 3 things alcohol increases the risk of?

Answer 8

• Subdural hematomas
• Closed head injuries
• Chronic meningitis

Question 9

Normal pressure hydrocephalus can be fixed via what mechanism?

Answer 9

• shunting of the CSF

Question 10

What are the risk factors of Multi-infract dementia?

Answer 10

• Cardiac disease
• HTN
• Age
• Diabetes

Question 11

What are the 3 major infections that causes dementia?

Answer 11

• HIV
  
  • Younger pt w/risk factors
  • opportunistic infections
• Cryptococcalmeningitis
  
  • HIv or transplant pts
• Neurosyphilis
  
  • FTA (+)
  • Abnormal neurological exam
  • Abnormal spinal fluid

Question 12

Name the four types of treatment for AD

Answer 12

• Neucleus basalis of meynert (cholinergic)
• Acetylcholinesterase inhiibitors
  
  • Donepezil
  • Rivastigmine
  • Galatamine
• NMDA glutamate antagonist
  
  • memantine
• Other
  
  • NSAIDs, estrogen, ginko all failed PRDB testing

Question 13

Name 3 Acetylcholinesterase inhibitors used to treat AD

Answer 13

• Donepezil
• Rivastigmine
• Galantamine

Question 14

What are some characteristics of Demenia with lewy bodies

Answer 14

• imparied cognition precedes diagmosis of parkinsons
• Initial symptoms
  
  • visual hallucinations
  • REM sleep disorders
  • delirium
• Spares memory initally (affects of frontal and executive functions
• Parkinsonism follows the cognitive changes

Question 15

Name 3 characterisitc findings of Huntington’s disease

Answer 15

• Dementia, chorea and dominant inhertiance
• Trinucleuotide repeat (chromosome 4)
• Caudate atrophy!