Chapter 8 neurology, Alzheimer's

Question 1

What are the differential diagnosis for dementia?

Answer 1

Alzheimer’s, Vascular dementia, Parkinson’s disease, Louis body dementia, frontal lobe dementia, reversible dementia

Question 2

What are the examples of reversible dementia?

Answer 2

B12 deficiency, hypothyroidism, depression, alcohol related, normal pressure hydrocephalus

Question 3

What are the routine test I should be done for dementia patients?

Answer 3

Noncontrast CT/MRI of the head/brain, vitamin B 12 level, TSH

Question 4

What are the pertinent findings on noncontrast CT scan for Alzheimer’s disease?

Answer 4

Periventricular leukomalacia and cortical atrophy. Absence of hydrocephalus and stroke

Question 5

What ages can slow down the progression for Alzheimer’s dementia?

Answer 5

Acetylcholinesterase donepezil rivastigmine or galantamine
Memantine
Vitamin E

Question 6

How can my memantine be used?

Answer 6

As adjunct along with cholinesterase inhibitor or the substitute if intolerant to cholinesterase inhibitors

Question 7

Which of vitamin E be used?

Answer 7

For Alzheimer’s if the patient doesn’t have heart disease

Question 8

What should we use for the patients paranoia Associated with Alzheimer’s?

Answer 8

Atypical antipsychotics (such as olanzapine)

Question 9

What are the dangers of using typical neuroleptics in Alzheimer patients?

Answer 9

Low potency can cause sedation and anti-cholinergic side effects which will worsen memory (Chlorpromazine).
High potency such as haloperidol can cause extraparametal side effects

Question 10

What are the other comorbid conditions that Alzheimer’s patient can suffer from?

Answer 10

Depression anxiety insomnia

Question 11

What treatment can be given to patients with Alzheimer’s comorbid conditions?

Answer 11

Fluoxetine, Buspirone, sleep hygiene

Question 12

What is the counseling aspect for Alzheimer’s patients?

Answer 12

Counseling of patient and family, medication compliance, good nutrition, occupational therapy, cognitive rehabilitation, support groups, medic alert bracelet, no driving, advance directives

Question 13

What physical examinations should be done for patients with Alzheimer’s

Answer 13

Complete

Question 14

What diagnostic test should be done for Alzheimer’s patients?

Answer 14

CBC BMP LFTs vitamin B 12 level TSH CT scan and lipid profile