Dementia Flashcards

1
Q

progressive decline in intellectual function that is severe enough to compromise social or occupational funcitoning, but without disturbance in consciousnesss

A

dementia

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2
Q

how is dementia usually acquired? (2)

A

neurodegenerative disease
stroke

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3
Q

what is the most common cause of dementia?

A

alzheimer disease (AD)

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4
Q

characterized by the overproduction and/or decreased clearance of amyloid beta peptides and alteration in the shape of tau

A

Alzheimer disease

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5
Q

what is the pathogenesis of Alzheimer disease?

A

neuritis plaques associated with neuronal injury leading to gross atrophy

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5
Q

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)?

A

Alzheimer disease
cholinesterase inhibitor (DRG) or memantine

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5
Q

characterized by damage in the area of ischemia after a stroke

A

vascular dementia

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6
Q

a patient presents with PMH of CVA and focal neurological deficits. what is their dx?

A

vascular disease dementia

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7
Q

characterized by an abnormal collection of lewy bodies in neurons of brain cortex

A

lewy body dementia

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8
Q

where in the brain does lewy body dementia usually occur? (2)

A

anterior frontal lobe
temporal lobe

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9
Q

a patient presents with visual hallucinations, fluctuating delirium, anxiety, and cognitive dysfunction. what is their dx and treatment?

A

lewy body dementia
cholinesterase inhibitors (DRG) +/- memantine

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10
Q

characterized by abnormal protein inclusions in the cytoplasm/nuclei of neuronal and/or glial cells

A

frontotemporal dementia

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11
Q

what are the 3 types of frontotemporal dementia?

A

behavioral
semantic
progressive nonfluent aphasia

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12
Q

what are the 2 most important parts of the history in evaluating a patient for dementia?

A

ADLs
depression screening

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13
Q

what evaluation should be done in patients over 70?

A

quick screen with 3 nouns + clock test

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14
Q

what should we do if a patient has any deficit in the quick screen?

A

full mini mental state exam (MMSE)

15
Q

what should we do if a patient has any deficit in MMSE?

A

full neuropsych eval

16
Q

what imaging can be ordered for dementia? (2)

A

MRI
CT

17
Q

what imagining can help differentiate between Alzheimer disease and frontotemporal dementia?

A

PET scan

18
Q

what 2 labs should be done in every patient?

A

B12
FT4/TSH

19
Q

what lab should be done if we are concerned for Alzheimer disease?

A

CSF analysis

20
Q

what can decrease the rate of decline in dementia? (2)

A

aerobic exercise
mental stimulation

21
Q

what SSRIs can be used for depression in dementia? (2)

A

bupropion
venlafaxine

22
Q

what med can be used for insomnia in dementia?

A

trazadone

23
Q

what med can be used for apathy in dementia?

A

methylphenidate (ritalin)

24
Q

why should methylphenidate (ritalin) be used only in selected patients?

A

can cause agitation