Dementia

Question 1

definition of eementia:

Answer 1

a decline in memory and at least one other cognitive function. the deficits should not be accounted for by another psychiatric condition.

Question 2

degenerative causes of demential are determined definitively

Answer 2

at autopsy

Question 3

alzheimers
diffuse lewy body disease
parkinsons disease
FTLD
PSP, CBD
MSA
huntingtons
olivopontocerebellar degeneration

Answer 3

degenerative causes of dementia

Question 4

Multiple infarction, 
single stroke
binswanger's disease
vasculitis
SAH

Answer 4

vascular causes of dementia

Question 5

fungal meningitis
syphilis
aids 
Creutzfeldt Jakob dz
post-herpes simplex encephalitis

Answer 5

infectious causes of dementia

Question 6

depression, alcohol abuse, drug related disorder, personality disorder, anxiety disorder

Answer 6

psychiatric causes of dementia

Question 7

vitamin B12 deficiency
thyroid failure
system failure - liver, renal, cardiac, respiratory
heavy metals 
toxins

Answer 7

toxic/metabloc causees of dementia

Question 8

subdural hematoma
closed head injury
open head injury
pugalistic brain injury
anoxic brain injury

Answer 8

traumatic cause of dementia

Question 9

glioblastoma
lymphoma
metastatic tumor (salt and pepper)

Answer 9

Tumors that cause dementia

Question 10

examination of demetia patient

Answer 10

MMSE, look for cardiovascular risk factors (anything that clues you in to multiple strokes)
full neuro exam.

bloodwork and MRI= look normal for age early in the disease

Question 11

Criterion for dx of alzheimers

Answer 11

dimentia established by MMSE, deficits in 2 or more areas of cognistion. progressive worsening. no disturbance of consciousness, onset between 40 and 90. absence of systemic disorders or other brain diseases that could account for the progressive deficits in memory and cognition.

Question 12

treatment of alzheimers

Answer 12

slow progression
Ach inhibitors - donezepil, rivastimine, galantamine
NMDA R agonist - Memantine

Question 13

How does mild cognitive impairment differ from alzheimers

Answer 13

memory complaint by the pt. tested abnormal memory for age, yet doesn’t meet criteria for dementia.
ACHeI medications

Question 14

how does vascular dementia differ from alzheimers

Answer 14

= dementia + cerebrovascular disease
single big stroke or multiple little strokes.
If it’s vascular you will see focality on the exam. like aphasia, dysphasia, motor, visual abnormality.

Question 15

Tetrad of symptoms in lewey body disease

Answer 15

alzheimers like dementia
parkinsonian symptoms
psychotic symptoms
extreme sensitivity to antipsychotic agents

Question 16

Lewey body disease

Answer 16

progresses more rapidly than alzheimers
symptoms vary from one day to the next
unexplained falls a lot
unxplained periods of increased confusion that lasts days - weeks, and closely mimics delirium

parkinson features often present early. treemor absent, poor response to levodopa. 
Psychotic symptoms (early in dz) - hallucinations are not bothersom, generally animals or people

Question 17

parkinsons vs diffuse lewey bodyq

Answer 17

parkinsons
=midbrain lewy bodies. dementia occurs LATE. Tremor. hallucinations d/t anti parkinsons drugs

lewey body disease
= cortical diffuse lewey bodies. dementia occurs early. prominent autonomic dysfunction. hallucinations common in absence of drugs

Question 18

Frontotemporal lobar degeneration (picks disease)

Answer 18

inappropriate emotional stuff. changes in personality with impairment of intellect memory and language. varies grately in how it effects indifiduals. atrophy of frontal and temporal lobes.

lack of memory, lack of spontaneity, difficulty in thinking or concentrating, disturbances of speech

Question 19

Normopressure hydroceph triad

Answer 19

dementia
gait disturbance
urinary incontinence

Question 20

most likely feature of normal pressure hydrocephalus to be improved with shunting

Answer 20

gait distrubances.