Cognitive DO Flashcards
Sopped at vascular dementia
What percentage of medically admitted patients exhibit delirium?
10-30%
What type of hallucinations are common in delirium?
Visual
MC finding in delirium?
Impairment in recent memory
Delirium + focal neurologic s/s: Dx and confirmatory test?
CVA or mass lesion; Brain CT/MRI
Delirium + elevated BP + papilledema: Dx and confirmatory test?
HTNsive encephalopathy; Brain CT/MRI
Delirium + dilated pupils + tachycardia: Dx and confirmatory test?
Drugs; urine tox screen
Delirium + fever + nuchal rigidity + photophobia: Dx and confirmatory test?
Meningitis; LP
Delirium + tachycardia + tremor + thyromegaly: Dx and confirmatory test?
Thyrotoxicosis; T4/TSH
What major class of drugs in CI in delirium because they can paradoxically exacerbate it?
BNZs
2 MCCs of dementia?
AD > vascular dementia
Dementia + normal CT. What test(s) should you order next?
MRI + complete metabolic panel
Work-up for reversible causes of dementia?
CBC Electrolytes TFTs VDRL/RPR B12/folate Brain CT or MRI
Dementia + stepwise deterioration + focal neuro signs: Dx and confirmatory test?
Multi-infarct dementia; CT/MRI
Dementia + cogwheel rigidity + resting tremor: Dx and confirmatory test?
Lewy body dementia or PD (depends on timeline); clinical dx
Dementia + gait apraxia + urinary incontinence + dilated ventricles: Dx and confirmatory test?
NPH; CT/MRI
Dementia + obesity + coarse hair + constipation + cold intolerance: Dx and confirmatory test?
Hypothyroidism; TSH/T4
Dementia + decr vibration/position sense + megaloblastic anemia: Dx and confirmatory test?
B12 deficiency; serum B12 (although I think world/FA for step 1 said methylmalonic acid levels are better)
Dementia + tremor + abnormal LFTs + copper rings around the eyes: Dx and confirmatory test?
Wilson dz; ceruloplasmin
Dementia + decr vibration/position sense + Argyll Robinson pupils: Dx and confirmatory test?
Neurosyph; CSF FTA-ABS or CSF VRRL
MMSE: dysfunction present under what score?
<25
Describe EEG in delirium vs dementia
Normal in dementia
Fast waves or generalized slowing in delirium
Neurochemical problems in AD?
Loss of noradrenergic neurons in basal ceruleus + decr choline acetyltransferase–> decr Ach
AD: how long from dx to death?
10 yr
3 genes linked to early onset AD?
Presenelin I or II; APP
Senile plaques and neurofibrillary tangles are found in what 2 other conditions besides AD?
Down syndrome
Normal aging
Gross brain findings in AD?
Diffuse atrophy w/ enlarged ventricles + flattened sulci
Which correlates w/ severity of dementia in AD: neuritic plaques or neurofibrillary tangles?
Plaques
Cholinesterase inhibitors are indicated for what severity of AD?
Mild-moderate
NMDA antagonists are indicated for what severity of AD?
Moderate-severe
