B7-065 CBCL Multi-Infarct Dementia Flashcards
cognitive deficits impairing social or occupational functions
dementia
syndrome that is
acquired
persistent
affects multiple cognitive domains
dementia
poor planning
location of deficit:
domain of deficit:
location of deficit: frontal lobes
domain of deficit: executive dysfunction
inattentive
location of deficit:
domain of deficit:
location of deficit: dorsolateral prefrontal cortex
domain of deficit: complex attention
inability to form new memories
location of deficit:
domain of deficit:
location of deficit: bilateral Papez circuit
domain of deficit: memory
aphasia
location of deficit:
domain of deficit:
location of deficit: dominant hemisphere
domain of deficit: language
agnosia (inability to process higher sensory info)
location of deficit:
domain of deficit:
location of deficit: perceptual centers in back of brain
domain of deficit: perceptual
apraxia (inability to perform a learned task)
location of deficit:
domain of deficit:
location of deficit:
domain of deficit: perceptual motor
no empathy
location of deficit:
domain of deficit:
location of deficit: orbito-frontal
domain of deficit: social cognition
problem in single cognitive domain
mild cognitive impairment (MCI)
(like only short term memory issue)
present with subjective cognitive complaints, but perform well on neuro exam
subjective cognitive impairment (SCI)
risk factors for AD actually increase risk for […] in general
dementia
APOE4 increases risk of developing […] onset dementia
later (after 65)
PSEN1, PSEN2 and APP increases risk of developing […] onset dementia
early (in 40s and 50s)
any pathologic process that damages the cerebral hemispheres can cause
dementia
amyloid and tau are associated with
AD
ischemia and amyloid angiopathy are associated with
vascular dementia
a-synuclein is associated with
diffuse lewy body dementia
hippocampul sclerosis is a common cause of
temporal epilepsy
which is the most prevalent cause of dementia?
if mixed pathology is an answer choice, choose that
if not, 1. AD 2. vascular 3. LBD
short term memory loss
temporal lobe epilepsy
hippocampal sclerosis
why is hippocampal sclerosis commonly misdiagnosed as AD?
short term memory loss is primary symptom
AD typically starts in the
medial temporal lobe
if AD starts in the inferior temporal lobe, the patient will present with
prosopagnosia
(inability to recognize faces)
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
