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Neuro 2 Mine > Delirium, Dementia, Degenerative Disease > Flashcards

Delirium, Dementia, Degenerative Disease Flashcards

1
Q

Delirium Definition

A
  • acute confusional state
  • state of diffuse brain dysfunction
  • rapid course
  • often called toxic metabolic encephalopathy
  • fluctuating LOC
  • impaired attention
  • incoherent speech
  • toxic/metabolic causes usually found
  • typically reversible
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2
Q

Dementia

A
  • chronic disorder
  • normal LOC
  • normal attention
  • aphasia
  • typically irriversible
  • deficits in at least three of the following: memory, language, visuospatial skills, complex cognition, emotion/personality
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3
Q

Differential Dx Of Delirium

A
  • dementia
  • amnesia
  • aphasia
  • schizophrenia
  • mania
  • depression
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4
Q

Tx of Delirium

A
  • adequate sleep (avoid daytime naps) (trazedone, zolpidem)

- drugs for agitation (atypical antipsychotics, benzodiazepines)

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5
Q

Deficiency of What Vitamin Leads to Reversible Dementia?

A

Vitamin B12

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6
Q

Cortical Dementia

A

Alzheimer Disease

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7
Q

Subcortical Dementia

A

Parkinson Disease

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8
Q

White Matter

A

Binswanger Disease

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9
Q

Mixed Dementia

A

Multi-Infarct Dementia

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10
Q

Alzheimer Disease

A
  • higher prevalence in women
  • three stages with third being the worst
  • cerebral atrophy
  • amyloid plaques and neurofibrillary tangles in hippocampus (required for dx)
  • acetylcholine deficit
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11
Q

Genetics of Alzheimer Disease

A
  • APP gene on chromosome 21
  • presinilin 1 on chromosome 14
  • presinilin 2 on chromosome 1
  • apolipoprotein E4 on chromosome 19 (APOE2 is protective)
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12
Q

Frontotemporal Dementia (FTD)

A
  • cortical dementia that selectively affects the frontal/temporal lobes
  • Pick Disease
  • behavioral disorders occur early before memory loss
  • tau (neurofibrillary tangles)
  • serotonin
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13
Q

Parkinson Disease

A
  • loss of dopaminergic cells in midbrain substantia nigra
  • cholinergic deficit present
  • sx: tremor, rigidity, bradykinesia
  • synuclein
  • dopamine deficit
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14
Q

Huntington Disease

A
  • autosomal dominant
  • dementia and chorea common
  • dx with CAG repeat
  • neuroleptics and tetrabenazine help chorea
  • imaging shows caudate atrophy
  • polyglutamine
  • paternal inc. in CAG
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15
Q

White Matter Dementia

A
  • genetic, demyelinative, infectious, inflammatory, toxic, metabolic, vascular, traumatic, neoplastic, hydrocephalic
  • ex. binswingers disease, normal pressure hydrocephalus
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16
Q

Binswanger’s Disease (BD)

A
  • vascular dementia featuring severe cerebral white matter ischemia
  • apathy, confusion, memory loss, depression, anxiety, gait disorder, etc
  • gradual progression
  • imaging: thickened and hyalinizing penetrating arterioles, white matter volume loss
  • caused by uncontrolled hypertension
17
Q

Normal Pressure Hydrocephalus

A
  • potentially reversible dementia
  • wet, wacky, wobbly (dementia, gait disorder, urinary incontinence)
  • high volume lumbar tap
  • imaging: large ventricles
  • tx: shunt
  • episodic pressure inc.
18
Q

Multi-Infarct Dementia (MID)

A
  • vascular dementia
  • combination of strokes
  • prevention and tx of stroke are crucial
  • compilation of lacunar infarcts
19
Q

Creutzfeldt-Jakob Disease (CJD)

A
  • rapidly progressive dementia
  • myoclonus is sign (shock like contraction of limbs)
  • cause is prion
  • no tx
  • sporadic (faster), infectious, inherited
  • variant is mad cow disease
20
Q

Lewy Body Dementia

A
  • early Parkinsonian features, psychosis (fixed false belief), fluctuating consciousness
  • acetylcholine and dopamine deficit
21
Q

Progressive Supranuclear Palsy

A
  • bradykinesia, rigidiy, falls, abnormal verticle eye movement
  • tau
22
Q

Amyotrophic Lateral Sclerosis

A
  • weakness and atrohpy
  • fasiculations
  • both upper and lower motor neuron signs
23
Q

Kuru

A

-prion disease in Papua New Guinea

24
Q

Gerstmann-Straussler-Sheinker Syndrome

A
  • autosomal dominant
  • cerebellar findings (clumsiness, incoordination, gait ataxia)
  • presence of dementia depends upon family
25
Q

Fatal Familial Insomnia

A
  • autosomal dominant
  • 35-60 years of age
  • progressive insomnia
  • memory loss
  • confusion
  • hallucinations

Neuro 2 Mine (9 decks)

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