Behavioral neurology II Flashcards
1
Q
dementia is diagnosed when:
A
- symptoms interfere with functioning at work or with usual activities AND
- represent a decline from previous levels of functioning AND
- are not explained by psychiatric disorder or delirium AND
- cognitive impairment is detected and diagnosed through history taking from a patient and a knowledgeable informant AND
- an objective cognitive assessment
2
Q
which tests are done for evaluation of dementia?
A
- blood work for reversible causes
- MRI (better than CT)
3
Q
what is the clinical triad for normal pressure hydrocephalus?
A
- dementia
- gait disturbance
- bladder dysfunction
“wet wobbly wacky”
4
Q
what are the mild cognitive impairment criteria?
A
- change in cognition IN COMPARISON WITH THE PERSON’S PREVIOUS LEVEL
- impairment in one or more cognitive domains
- impairment in episodic memory
5
Q
how do you differentiate MCI vs dementia?
A
- determination of whether or not there is SIGNIFICANT interference in the ability to function at work or in usual daily activities
- clinical judgment made by a skilled clinician
6
Q
what are the 3 subtypes of FTD?
A
- frontal variant
- Broca’s
- Wernicke’s
7
Q
what are the CORE features of dementia with lewy bodies?
A
- EARLY visual hallucinations
- fluctuating cognition with pronounced variations in attention and alertness
- parkisonism
8
Q
what are the CENTRAL features of dementia with lewy bodies?
A
- dysexecutive syndrome (difficulty planning, attention and concentration problems predominant)
- memory less affected
9
Q
vascular dementia is associated with mutation in what gene?
A
NOTCH-3 (CADASIL)
10
Q
what are the side effects of acetylcholinesterase inhibitors?
A
- GI disturbance
- vivid dreams
- increased agitation
11
Q
what is the MOA of memantine?
A
partial NMDA receptor leak current blocker
12
Q
what drugs should be discontinued in AD patients?
A
- anticholinergic medications (tylenol PM)
- sedatives
