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Neuro Module > Dementia > Flashcards

Dementia Flashcards

1
Q

Definition of dementia

A
  • a syndrome of progressive and significant impairment of ADL
  • memory loss + 1 other cognitive impairment (language, visuospatial ability, calculation, judgement, problem solving)
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2
Q

Major RFs of dementia

A

age, fhx, low education level, females, vascular disease (smoking, DM, BMI>30, HTN)

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3
Q

Mild cognitive impairment

A

measurable cognitive impairment that does NOT disrupt ADL

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4
Q

Neurobiology of dementia

A
  • Disruption of cerebral neuronal circuits
  • Memory and cognitive functions (ACh receptors)
  • Behavior and mood (noradrenergic, serotonin, dopamine)
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5
Q

Alzheimer’s Disease on imaging

A

diffuse atrophy of cerebral cortex, secondary enlargement of ventricular system, amyloid plaques

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6
Q

AD symptoms

A

MEMORY

frontal lobe: anosognosia, executive fxtn impairment (navigation)
parietal/temporal: aphasia, visuospatial skills
Hippocampus: impaired ability to form new memories

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7
Q

Frontal lobe impairment

A

executive function

anosognosia

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8
Q

Parietal/temporal impairment

A

Language

Visual-spatial skills

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9
Q

Hippocampus impairment

A

impaired ability to form new memories

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10
Q

2 types of vascular dementia

A

multi-infarct

diffuse white matter

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11
Q

multi-infarct vascular dementia signs on PE

A

focal neuro signs: hemiparesis, unilateral Babinski, visual field defect

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12
Q

multi-infarct vascular dementia on imaging

A

multiple lesions with focal damage

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13
Q

diffuse white matter vascular dementia

A

Chronic ischemia small vessels

Insidious and slowly progressive

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14
Q

diffuse white matter vascular dementia signs

A

Pyramidal signs

Cerebellar signs

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15
Q

signs of frontotemporal dementia

A

behavior/mood changes - poor personal and social skills, repetitive behaviors, disinhibition

MEMORY spared

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16
Q

Pick’s disease

A

rare subset of frontotemporal dementia with Pick’s bodies on microscope

17
Q

Parkinsonian dementia

A

dementia follows Parkinson’s disease

18
Q

What are Lewy Bodies?

A

very tiny abnormal protein structures found in brain neurons

19
Q

CJD

A 
prion disease of infectious proteins
rapidly progressive dementia
issues with muscle coordination
myoclonus
eventually can't move or speak and enter coma
subtypes: Kuru, Mad Cow
20
Q

Huntington’s Disease

A
  • autosomal dominant degenerative brain disorder

- chorea, behavior disturbances, executive impairment

21
Q

Wernicke’s Encephalopathy

A 
MALNOURISHED individual (freq alcoholic)
Vit B1/thiamine deficiency
22
Q

Where does Vit B12 absorption occur?

A

distal ileum

23
Q

Korsakoff’s Syndrome

A

IRREVERSIBLE dementia from CHRONIC B1 deficiency

24
Q

Vit B12 deficiency

A

pernicious anemia

25
Q

Lewi Body dementia

A

Abnormal aggregates of proteins that develop in nerve cells of substantia nigra and cortex in PARKINSON’S DISEASE

Dementia precedes Parkinsons

26
Q

Most common cause of dementia

A

Alzheimer’s (55%)

27
Q

Drugs that increase incidence of dementia

A

ANTICHOLINERGICS
Tricyclic antidepressants (doxepin)
antihistamines (chlorpheniramine)
antimuscarinics for bladder control (oxybutynin)

28
Q

Meds to treat cognitive symptoms

A

Cholinesterase inhibitors: Donepezil (Aricept)

Neuropeptide Modifying Agents: Memantine (Namenda) - blocks glutamine

29
Q

Meds to treat behavioral symptoms

A

SSRI: Prozac (fluoxetine), Celexa (citalopram)

Antipsychotics: Risperdone (risperdal)

30
Q

Diffuse atrophy of cerebral cortex

A

Alzheimer’s

31
Q

How is dementia different than delirium?

A
  • delirium has rapid onset (dementia insidious and progressive)
  • delirium involves hallucinations, agitation, and clouded consciousness (dementia doesn’t)
32
Q

Primary deficit of delirium is ______.

A

attention

33
Q

Primary deficit of delirium is ______.

A

attention

34
Q

How are dementia and delirium the same?

A

both have memory impairment and confusion

35
Q

78 yo who has is admitted due to visual hallucinations, inconsistent participation in personal care activities, inability to manage at home.

DDXs?

A

Lewy Body dementia
Alzheimer’s/vascular dementia
Delirium

36
Q

Medication with biggest risk of delirium

A

Benzodiazepines

37
Q

When is the best time to use benzodiazepines for delirium?

A

using benzos for alcohol withdrawal and DTs (delirium tremors) can be life-saving

  • also use for acute seizures

Neuro Module (13 decks)

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