Dementia Flashcards
Work up for dementia?
CBC, ESR, BMP, TSH,
Infections: VDRL, HIV, urinalysis, CXR
Nutrition: B12 and folate
Head MRI/CT
Patient would likely dementia – next diagnostic steps? Probable treatment?
Assessment depression and reversible causes of dementia. AChE inhibitor
Definition of dementia?
Impairment of memory and at least one other cognitive function without alteration of consciousness
Multi-infarct dementia?
Dementia in the setting of cerebrovascular disease, occurring after multiple cerebral infarctions
Delirium?
Acute or subacute onset of confusion with a fluctuating level of consciousness
Cognitive decline occurs with prominent mood disturbance consider? Tx?
Depression or pseudodementia (Treat with empiric Trial of antidepressants)
If patient has a history of irregular stepwise declining functioning or known cardiovascular disease/atrial fibrillation consider?
Multi-infarct dementia or Binswanger disease
Binswanger disease
Patient with long-standing hypertension or cerebrovascular disease who develops insidious, diffuse subcortical white matter changes
Common causes of dementia?
- Depression
- Multi-infarct dementia
- Alcoholism
- Parkinsonism
Infectious causes of dementia?
HIV dementia or neurosyphilis
Hormonal causes of dementia?
Hypothyroidism
Reversible form of dementia presents with a classic triad? Tx?
Normal pressure hydrocephalus. Classic triad of dementia, gate disturbance, and urinary or bowel incontinence (wet, wobbly, and wacky)
Treat with ventriculoperitoneal shunt
Treatment options for Alzheimer’s disease?
Cholinesterase inhibitors: donepezil, rivastigmine, galantamine
NMDA antagonists: memantine
Drug to reduce psychotic symptoms and aggression in patients with dementia?
Risperidone
Common findings in brain imaging patients with Alzheimer’s disease?
Enlarged cerebral ventricles and brain atrophy
