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NMSP Exam 1 > Approach to Dementia > Flashcards

Approach to Dementia Flashcards

1
Q

what are the degenerative causes of dementia?

A 
Alzheimers 
Lewy body disease
Parkinsons
Frontotemporal lobar degeneration
Progressive supranuclear palsy
Corticobasal degeneration 
Multiple system atrophy
Huntingtons
Olivopontocerebellar degeneration
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2
Q

what are the vascular causes of dementia?

A 
multiple infarctions
single stroke
binswanger's disease
vasculitis
subarachnoid hemorrhage
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3
Q

what are the infectious causes of dementia?

A 
fungal meningitis
syphilis
AIDS
CJD
post-herpetic encephalitis
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4
Q

what are the psych causes of dementia?

A 
depression
alcohol abuse
drug-related disorder
personality disorder
anxiety disorder
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5
Q

what are the toxic/metabolic causes of dementia?

A 
Vit B12 deficiency
thyroid deficiency
system failure
heavy metals
toxins
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6
Q

what are the traumatic causes of dementia?

A 
subdural hematoma
closed head injury
open head injury
chronic traumatic encephalopathy
anoxic brain injury
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7
Q

what is important when getting a history on a patient with possible dementia?

A

interviewing both the patient and a family member/caregiver

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8
Q

what is a standard PE for a patient with possible dementia?

A

standardized short mental state test
assess CV risks
full neuro exam

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9
Q

what labs should you order to r/o dementia?

A 
CBC
CMP
sed rate
thyroid function
B12 levels
RPR
LP
HIV testing
drug screen
heavy metal screen
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10
Q

what imaging should you order to r/o dementia?

A

CT or MRI
EEG
CXR
PET scan

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11
Q

what are the criteria for diagnosing Alzheimers disease?

A

established by mini-mental state exam

deficits in 2 or more areas of cognition

progressive worsening of memory and other cognitive functioning

no disturbance of consciousness

absence of systemic disorders or other brain diseases

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12
Q

what findings would support an Alzheimers diagnosis?

A 
progressive deterioration of aphasia, apraxia or agnosia
impaired activities of daily living 
family hx of dementia
normal LP
normal EEG
progressive atrophy on MRI or CT
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13
Q

what is the definition of mild cognitive impairment (MCI)?

A

tested abnormal memory for age but does not meet the criteria for dementia

  • normal general cognitive function
  • normal daily activities
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14
Q

what is the relationship between MCI and Alzheimers?

A

patients with MCI are 5x more likely to develop Alzheimers

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15
Q

what is the relationship between stroke and dementia?

A

strokes tend to cause dementia within 3 months

can also result in abrupt deterioration in cognitive functions or fluctuating cognitive deficits

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16
Q

what is the tetrad of diffuse lewy body disease?

A

dementia
parkinsonian symptoms
psychotic symptoms
extreme sensitivity to antipsychotic agents

17
Q

what is the pattern of LBD compared to Alzheimers?

A

often progresses more rapidly
symptoms vary more than sx of alzheimers
psych sx are much more common

18
Q

what should you absolutely not give someone with LBD?

A

anti-psychotics!!

can result in a potentially life-threatening reaction

19
Q

compare and contrast Parkinsons vs LBD

A 
Parkinsons:
Midbrain lewy bodies
dementia occurs late in illness
resting tremor
hallucinations in response to drugs
LBD:
cortical lewy bodies
dementia occurs early in illness
no resting tremor
autonomic dysfunction
hallucinations without drugs
20
Q

what is frontotemporal degeneration?

A

umbrella term for multiple forms of dementia characterized by deterioration in social skills and changes in personality

includes impairment of intellect, memory, and language

21
Q

what are the core symptoms of FTD?

A

loss of memory
lack of spontaneity
difficulty concentrating
disturbances of speech

22
Q

what can be seen on CT/MRI in FTD?

A

frontal and temporal atrophy

23
Q

what is the triad of normal pressure hydrocephalus?

A

wacky
wobbly
wet

24
Q

how does CADASIL contribute to developing dementia?

A

multiple areas of ischemia causing subcortical dementia

NMSP Exam 1 (17 decks)

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