Dementia Flashcards
progressive decline in intellectual function that is severe enough to compromise social or occupational funcitoning, but without disturbance in consciousnesss
dementia
how is dementia usually acquired? (2)
neurodegenerative disease
stroke
what is the most common cause of dementia?
alzheimer disease (AD)
characterized by the overproduction and/or decreased clearance of amyloid beta peptides and alteration in the shape of tau
Alzheimer disease
what is the pathogenesis of Alzheimer disease?
neuritis plaques associated with neuronal injury leading to gross atrophy
a 67 year old patient presents with short-term memory loss, decreased executive function, decreased visuospatial function, and language deficits. what is their dx and treatment (2)?
Alzheimer disease
cholinesterase inhibitor (DRG) or memantine
characterized by damage in the area of ischemia after a stroke
vascular dementia
a patient presents with PMH of CVA and focal neurological deficits. what is their dx?
vascular disease dementia
characterized by an abnormal collection of lewy bodies in neurons of brain cortex
lewy body dementia
where in the brain does lewy body dementia usually occur? (2)
anterior frontal lobe
temporal lobe
a patient presents with visual hallucinations, fluctuating delirium, anxiety, and cognitive dysfunction. what is their dx and treatment?
lewy body dementia
cholinesterase inhibitors (DRG) +/- memantine
characterized by abnormal protein inclusions in the cytoplasm/nuclei of neuronal and/or glial cells
frontotemporal dementia
what are the 3 types of frontotemporal dementia?
behavioral
semantic
progressive nonfluent aphasia
what are the 2 most important parts of the history in evaluating a patient for dementia?
ADLs
depression screening
what evaluation should be done in patients over 70?
quick screen with 3 nouns + clock test
what should we do if a patient has any deficit in the quick screen?
full mini mental state exam (MMSE)
what should we do if a patient has any deficit in MMSE?
full neuropsych eval
what imaging can be ordered for dementia? (2)
MRI
CT
what imagining can help differentiate between Alzheimer disease and frontotemporal dementia?
PET scan
what 2 labs should be done in every patient?
B12
FT4/TSH
what lab should be done if we are concerned for Alzheimer disease?
CSF analysis
what can decrease the rate of decline in dementia? (2)
aerobic exercise
mental stimulation
what SSRIs can be used for depression in dementia? (2)
bupropion
venlafaxine
what med can be used for insomnia in dementia?
trazadone
