B7-065 CBCL Multi-Infarct Dementia Flashcards by Felicia Jones

Q

cognitive deficits impairing social or occupational functions

A

dementia

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Q

syndrome that is
acquired
persistent
affects multiple cognitive domains

A

dementia

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Q

poor planning

location of deficit:
domain of deficit:

A

location of deficit: frontal lobes
domain of deficit: executive dysfunction

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Q

inattentive

location of deficit:
domain of deficit:

A

location of deficit: dorsolateral prefrontal cortex
domain of deficit: complex attention

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Q

inability to form new memories

location of deficit:
domain of deficit:

A

location of deficit: bilateral Papez circuit
domain of deficit: memory

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Q

aphasia

location of deficit:
domain of deficit:

A

location of deficit: dominant hemisphere
domain of deficit: language

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Q

agnosia (inability to process higher sensory info)

location of deficit:
domain of deficit:

A

location of deficit: perceptual centers in back of brain
domain of deficit: perceptual

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Q

apraxia (inability to perform a learned task)

location of deficit:
domain of deficit:

A

location of deficit:
domain of deficit: perceptual motor

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Q

no empathy

location of deficit:
domain of deficit:

A

location of deficit: orbito-frontal
domain of deficit: social cognition

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Q

problem in single cognitive domain

A

mild cognitive impairment (MCI)

(like only short term memory issue)

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Q

present with subjective cognitive complaints, but perform well on neuro exam

A

subjective cognitive impairment (SCI)

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Q

risk factors for AD actually increase risk for […] in general

A

dementia

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Q

APOE4 increases risk of developing […] onset dementia

A

later (after 65)

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Q

PSEN1, PSEN2 and APP increases risk of developing […] onset dementia

A

early (in 40s and 50s)

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Q

any pathologic process that damages the cerebral hemispheres can cause

A

dementia

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Q

amyloid and tau are associated with

A

AD

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Q

ischemia and amyloid angiopathy are associated with

A

vascular dementia

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Q

a-synuclein is associated with

A

diffuse lewy body dementia

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Q

hippocampul sclerosis is a common cause of

A

temporal epilepsy

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Q

which is the most prevalent cause of dementia?

A

if mixed pathology is an answer choice, choose that

if not, 1. AD 2. vascular 3. LBD

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Q

short term memory loss
temporal lobe epilepsy

A

hippocampal sclerosis

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Q

why is hippocampal sclerosis commonly misdiagnosed as AD?

A

short term memory loss is primary symptom

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Q

AD typically starts in the

A

medial temporal lobe

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Q

if AD starts in the inferior temporal lobe, the patient will present with

A

prosopagnosia

(inability to recognize faces)

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taupathies [3]

AD Frontotemporal dementia progressive supranuclear palsy (he said don't need to know this one)

beta amyloidopathies [2]

AD cerebral amyloid angiopathy

a-synucleinopathies [3]

Parkinson's Multi systems atrophy diffuse lewy body disease

TDP-43 -pathies [2]

frontotemporal dementia ALS

PRPNP disease

prions

standard dementia evaluation [4]

brain MRI thyroid function tests B12 CBC/CMP

optional tests for dementia evaluation [2]

CSF evaluation PET

reversible causes of dementia [5]

depression hypothyroidism vitamin B12 deficiency neurosyphillis normal pressure hydrocephalus

beta amyloid deposits in the wall of small to medium brain vessel

cerebral amyloid angiopathy

manifestations of cerebral amyloid angiopathy are related to

macro and micro hemorrhages (spectrum he was talking about)

sometimes associated with vasculitis

cerebral amyloid angiopathy (if it is related to vasculitis, steroids can help)

cerebral amyloid angiopathy can cause [...] hemorrhage

intraparenchymal

vascular dementia causes a [...] dementia pattern

subcortical

key that dementia is vascular

abnormalities on elementary neurological examination

principles of stroke prevention [3]

risk factor control antithombotic carotid artery stenting/endarterectomy

what brain locations are associated with agnosia?

perceptual sensory areas of the brain

most common abnormal protein aggregation associated with frontotemporal dementia

Tau

what do multiple subcortical hyper intensities on T2 weighted MRI tell you?

patient has increased risk of having vascular dementia, but not all patients with this finding have significant cognitive defects

disorientation in familiar areas can indicate

moderate dementia

a waxing and waning level of alertness is indicative of

delirium or encephalopathy

memorizing a sequence of numbers or words and reciting them back immediately is an example of [...] memory

working

the ability to remember up to minutes

short term memory

[...] memory is preserved in Alzheimer's until late in the course

working

the ability to use a keyboard is an example of [...] memory

procedural

remembering what you had for breakfast in the morning is an example of [...] memory

episodic

knowing the capital of the state is an example of [...] memory

semantic

[...] dementia involves predominately memory decline, specifically episodic memory (recent events), visuospatial deficits, and loss of executive function

Alzheimers

characterized by having a temporal relationship between a vascular event and onset of cognitive defects

multi-infarct dementic

slowed thinking and concentration is a typical feature of [...] dementia

multi-infarct

what cognitive function is NOT tested on the MMSE

executive function

FDG-PET scan shows hypometabolism in the temporal and parietal regions

AD

FDG-PET scan shows hypometabolism in the frontal and temporal lobes

frontotemporal dementia

FDG-PET scan shows hypometabolism in asymmetrical cortical areas

multi-infarct dementia

FDG-PET scan shows hypometabolism in the parieto-occipital areas

lewy body dementia

pure hemisensory loss is a [...] stroke syndrome and can be localized to the [...]

lacunar thalamus

Contralateral, involuntary, large flinging movements of the arm or leg

hemiballismus (subthalamic nucleus)

what is indicated in the setting of a fib to reduce risk of stroke?

warfarin or other anti-coag (as long as risk of bleeding does not outweigh benefits **dypridamole** may be indicated in that case)

cerebral amyloid angiopathy can cause [...] leading to vascular dementia

microhemorrhages (avoid anti-coags)

acetylcholinesterase inhibitors used in AD [3]

rivastigmine galantamine donepezil

indicated in AD for symptomatic benefit with memory and cognition

acetylcholinesterase inhibitors (rivastigmine galantamine donepezil)

side effects of acetylcholinesterase inhibitors

nausea vomiting diarrhea muscle cramps frequent urination weight loss bradycardia arrhythmias confusion fatigue

initial evaluations to order in suspected dementia cases [2]

driving home safety

APOE4 is associated with [...] onset AD

late (after 65)

signs of AD on brain MRI [3]

atrophy in hippocampus global atrophy ventricular enlargement

atrophy in the parieto-occipital regions on brain MRI

lewy body dementia

microhemorrhages and white matter disease on brain MRI

vascular dementia

therapies indicated to slow the progression of AD

none