434 Dementia with Lewy bodies

Question 1

Levy body disease can manifest as ____ and _____ diseases

Answer 1

PDD - Parkinson’s disease with Dementia

DLB - Dementia with Lewy Bodies

Question 2

________ in LBD affects performance of ADLS beyond other PD symptoms

Answer 2

Cognitive decline in LBD affects performance of ADLS beyond other PD symptoms

Question 3

Key neuropathologic features in LBD (2)

Answer 3

• Lewy body
• Lewy neurites

Question 4

Intraneuronal cytoplasmic inclusions

Answer 4

Lewy body

Question 5

Stains with PAS and ubiquitin

Answer 5

Lewy body

Question 6

Why PDD and DLB are classified as SYNUCLEINOPATHIES

Answer 6

Due to the presence of alpha-synuclein aggregates in neurons and glia of PDD and DLB

Question 7

Best predicts the clinical benefits and NOT the Lewy pathology per se (2)

Answer 7

Neuronal and Synaptic loss

Question 8

3 Stages of Progression in DLB

Answer 8

• Brainstem predominant
• Transitional limbic
• Diffuse neocortical

Question 9

Usual start of PD (location)

Answer 9

Enteric nervous system

Question 10

involved areas of the brain in Cholinergic vs Adrenergic deficit of DLB

Answer 10

Question 11

Mutations of ________particularly lead to DLB or PDD presentations

Answer 11

Mutations of **GBA (glucocerebrosidase) **particularly lead to DLB or PDD presentations

Question 12

7 biomarkers that can help distinguish LBD from AD

Answer 12

Question 13

differentiate LBD from AD based on polysomnogram

Answer 13

Question 14

differentiate LBD from AD based on CSF

Answer 14

Question 15

differentiate LBD from AD based on MRI

Answer 15

Question 16

differentiate LBD from AD based on PET SCAN (18F-deoxyglucose)

Answer 16

Question 17

differentiate LBD from AD based on AMYLOID PET scan

Answer 17

Question 18

differentiate LBD from AD based on MIBG myocardial scintigraphy

Answer 18

Question 19

differentiate LBD from AD based on DAT scan or PET dopamine scan

Answer 19

Question 20

4 meds for symptomatic treatment of LBD

Answer 20

Question 21

Example of cholinesterase inhibitors as tx for LBD (2)

Answer 21

Question 22

Example of atypical antipsychotics that can be given for symptomtic tx of LBD

Answer 22

Question 23

Selective inverse agonist of serotonin 5-HT2a receptor that can be used for symptomatic tx of LBD

Answer 23

Question 24

Known side effect of Pimavenserin

Answer 24

Question 25

Known adverse effect of Clozapine

Answer 25

Question 26

Why are DLB patients should not be exposed to Neuroleptics

Answer 26

Question 27

Why are DLB patients should not be exposed to anticholinergics or dopamine agonists

Answer 27

Question 28

Treatment for RBD

Answer 28

Question 29

Alternative agents for tx of RBD if unresponsive to first line drug (3)

Answer 29

Question 30

Treatment for mood and anxiety symptoms in LBD

Answer 30

Question 31

Non pharmacologic tx for orthostatic hypotension in LBD (3)

Answer 31

Question 32

Pharmacologic tx for orthostatic hypotension in LBD (3)

Answer 32

Question 33

Differentiate DLB from AD based on MCI

Answer 33

Question 34

Differentiate DLB from AD based on frequency and severity of fluctuating cognition with variations in attention

Answer 34

Question 35

Differentiate DLB from AD based on SLEEP

Answer 35

Question 36

Differentiate DLB from AD based on frequency recurrent visual hallucinations

Answer 36

Question 37

Main diagnostic features of DLB (5)

Answer 37

Question 38

Dementia and neuropsychiatric symptoms precede or co-emerge with the parkinsonism... PDD or DLB?

Answer 38

DLB

Question 39

Presents in px with long -standing PD , who manifest dementia often with visual hallucinations, fluctuating attention or alertness, and RBD...... PDD or DLB?

Answer 39

PDD

Question 40

More frequently has AD co-pathology ..... PDD or DLB?

Answer 40

DLB

Question 41

Episodic memory disturbance points to the diagnosis of comorbid AD .... True or false

Answer 41

True

Question 42

common DDX for DLB

Answer 42

Question 43

timing of occurence of autonomic disturbances in MSA... early or late?

Answer 43

Question 44

San mas severe ang autonomic disturbances.... DLB or MSA

Answer 44

Question 45

San mas common ang ANOSMIA... LBD or MSA

Answer 45

Question 46

difference between PD-MCI and MCI-DLB in terms of cognitive impairment

Answer 46