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Neurology > Dementia > Flashcards

Dementia Flashcards

1
Q

Confusion in older adults?

A

delirium

dementia

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2
Q

Delirium?

A 
disturbance of consciousness and change in cognition developing over a short pd of time; ATTENTION
problems attending (you cannot remember b/c you did not attend)
rapid onset
waxes and wanes
autonomic arousal
clouded consciousness
restless, agitated, lethargic
hallucination
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2
Q

Confusion in adults - cx?

A 
CVA/stroke
subdural hematoma
anxiety
metabolic - hypoglycemia
low BP
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3
Q

Dementia?

A 
a syndrome w/ progressive decline in daily living 
cognitive deficits in two areas
1) memory impairment 
2) amnesia, aphasia, apraxia, agnosia, anosognosia, executive functioning impairment
NOT d/t delirium or psychiatric dz 
insidous onset
progressive
NO autonomic arousal
conscious and alert
no hallucination
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4
Q

Amnesia?

A

memory prob

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5
Q

Aphasia?

A

language prob

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6
Q

Aprxia?

A

prob using familiar objects

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7
Q

Agnosia?

A

prob naming

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8
Q

Major cx of dementia?

A

alzheimer’s dementia +/-vascular dementia

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9
Q

What is alzheimer’s dementia?

A 
frontal temporal lobe dementia/Pick's dz
Parkinson's dz dementia-spectrum illness
Lewy body dementia
Huntington's dz
dementia d/t alcohol 
demential d/t head injury
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10
Q

Impairment of Alzheimers dz?

A

hippocampus
parietal/temporal lobes
frontal lobe impairment

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11
Q

Hippocampus cx?

A

cannot form new memories

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12
Q

Parietal/temporal lobes?

A

understanding and using languages, praxis, perception, visual-spatial skills

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13
Q

Dementia tx?

A

Memantine
cholinesterase inhibitors
valproate - anxiety, manic type

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14
Q

Frontal lobe impairment?

A 
complex cognition (exectuvie fxntioning)
insight (anosognosia)
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16
Q

Frontal temporal lobe dementia?

A

1) behavioral variant- personality change; impulsive vs apathetic
2) semantic dementia- SPEECH is impaired NOT the memory
3) nonfluent progressive aphasia- stuttering, lose ability to write

16
Q

Lewy body dementia?

A

read a contract and informed consent - able to form new memories
***visual hallucination or paranoia/delusion (sense are getting input but NOT getting input)
occipital lobe is VERY active
waxes and wanes w/in 24 hrs
overlaps w/ parkinsonism dementia
abnormal protein that develop in nerve cells of substantial nigra in PARKINSON’S DZ

17
Q

Anosogosia?

A

lack of appreciation of significance of deficits

they do not know who they are but refuse to acknowledge they have memory probs

18
Q

Anosognosia - cx?

A

prob w/prefrontal cortex or the right parietal lobe

19
Q

Dementia dx?

A

hx
MMSE; use SLUMS, MOCA
OT - functional assessments ( Allen cognitive; can they still pay bills, sewing, etc)
Neuropsychology: trails A & B

20
Q

What to be aware from pt and family?

A

hx from multiple sources (we should avoid asking yes/no questions)
vague answers
good neurological examination

21
Q

Criteria for delirium?

A

decreased awareness of environment - not able to focus, sustain or shift attention
memory, orientation, language, hallucination

22
Q

Delirium neurotransmitter deficit?

A

too much dopamine; too little Ach

23
Q

Delirium sx/PE?

A 
sleeping disturbances
psychomotor agitation
depression
myoclonus
stupor, coma, seizures
24
Q

Cx of delirium?

A

not working BBB**
hx of brain injury
infxn

25
Q

Delirium - RF?

A 
sensory deprivation (hearing/seeing)
young, old
male
severe illness
depressed
26
Q

Delirium - precipitating factors?

A

foley use

more than 3 use of drugs

27
Q

Prevention of delirium?

A 
get sleep
cognitive impaired
move them around
fix visual
fix hearing
28
Q

Tx delirium?

A 
withdraw alcohol, benzo (avoid in older adults)
avoid restraints
family education 
PT/OT
younger than 70? haloperidol
older than 70? riserpidone
30
Q

Prevent delirium in geriatrics that are admitted to ICU?

A 
sleep (10p-5a) - melatonin, mirtazapine
hydration
PO intake (warm food as warm, cold as cold)
moving/ambulatory 
say no to Benzo and TCA
31
Q

Wernicke’s encephalopathy?

A

malnourished

32
Q

Wernicke’s encephalopathy deficiency?

A

Vit B1/thiamine

33
Q

Wernicke’s encephalopathy population?

A

alcoholics

34
Q

Korsakoff’s syndrome?

A

irreversible dementia from B1 deficiency

35
Q

Alcohol withdrawal tx?

A

benzodiapine

36
Q

What can happen if wernicke’s encephalopathy get’s bad?

A

Korsakoff’s syndrome

37
Q

Cretzfeldt-jakob?

A

prior dz
accumulation of infectious proteins
dementia
anxiety

38
Q

AD first sx?

A

memory loss

39
Q

Vascular dementia first sx?

A 
apathy
falls
focal weakness
slowing of cognitive slowing
memory may be spared 
motor slowing
spasticity

Neurology (13 decks)

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