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Geriatrics Rotation PPTs > Dementia > Flashcards

Dementia Flashcards

1
Q

Disorder that causes significant decline in one or more areas of cognitve functioning severe enough to result in functional decline

A

Dementia

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2
Q

6-8 percent of those >/= 65 have AD, T/F?

A

True

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3
Q

Second most common cause of dementia in those over 65

A

Dementia w/ Lewy Bodies

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4
Q

Amyloid plaques and tau tangles

A

AD

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5
Q

Cytoplasmic alpha synuclein inclusion bodies

A

Lewy body and Parkinson Dementia

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6
Q

Tau or ubiquitin proteins

A

Frontotemporal dementia

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7
Q

Definite RF of dementia

A

Age, Fam Hx, APOE4 allele, Down syndrome

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8
Q

Possible protective factors of dementia

A

NSAIDs, antioxidants, intellectual activity, statin

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9
Q

Possible RF of dementia

A

Head trauma
Fewer years of formal education
CV RF

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10
Q

Examine the status of these 3 things on physical for dementia

A

Neurologic status
Mental Status
Functional Status

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11
Q

Labs for assesment of dementia

A

RPR, CBC, B12, TSH, Na, Ca, BUN/Cr, folate level, HIV Screen

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12
Q

When to consider imaging

A
  • onset of <65 y/o
  • sudden sx
  • neuro deficits
  • NPH clinical picture
  • Recent fall or head trauma
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13
Q

Order what type of imaging when looking at dementia/possible trauma

A

Noncontrast head CT
MIRI
PET scan (when dx uncertain)

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14
Q

Mild decline in memory
Needs more effort and time to recall new info
No impaired functioning
New learning slow, but still occurs

A

Normal aging

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15
Q

No impairment in independent living

Some convert to AD

A

Mild NCD/MCI

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16
Q

AD: Progression is gradual or rapid?

A

Gradual over 8-10 years on average

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17
Q

Labs for AD will be ____

A

Normal

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18
Q

imaging for AD will show ___

A

possible global atrophy, small hippocampal volumes.

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19
Q

Vascular dementia onset is __

A

Rapid

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20
Q

Vascular dementia progression is ____

A

gradual or stepwise w/ further ischemia

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21
Q

Lab test for vascular dementia are ____

A

normal

22
Q

Imaging for vascular dementia shows ____

A

cortical or subcortical changes on MRI

23
Q

Dementia w/ Lewy bodies have these cognitive sx

A

memory, visuospatial, hallucinations, fluctuating sx

24
Q

Motor sx of Dementia w/ Lewy bodies

A

parkinsonism

25
Q

Progression of Dementia w/ lewy bodies

A

gradual, but faster than AD

26
Q

Lab tests for dementia w/ lewy bodies are ___

A

Normal

27
Q

imaging for dementia w/ lewy bodies shows ___-

A

possible global atrophy

28
Q

Onset of frontotemporal dementia

A

gradual, usually age <60

29
Q

Executive, disinhibition, apathy, language, +/- memory deficits seen in this dementia

A

Frontotemporal dementia

30
Q

Motor sx for frontotemporal dementia

A

None

31
Q

Frontotemporal dementia progression

A

Gradual but faster than AD

32
Q

Lab tests for frontotemporal dementia are ____

A

Normal

33
Q

Imaging for frontotemporal dementia shows ____

A

atrophy in frontal and temporal lobes

34
Q

Patients w/ primary depression are generally unlike those w/ dementia in that they ___

A
  • demonstrate decreased motivation during cognitive testing
  • express cognitive complaints that exceed measured deficits
  • maintain intact language and motor skills
35
Q

Primary goal of dementia tx

A

Enhance quality of life

Maximize functional performance by improving or stabilizing cognition, mood, behavior

36
Q

Nonpharm management of dementia

A
  • Cognitive rehab
  • therapy
  • physical, mental activity
  • appts q 3-6 months
  • family/caregiver education and support
  • attention to safety
  • Environmental modification
37
Q

Pharm tx for dementia

A
  • Cholinesterase inhibitors: donepezil, rivastigmine, galantamine
  • Memantine
  • cognitive enhancers
  • antidepressants
  • psychoactive meds
38
Q

SE of cholinesterase inhibitors

A

GI SE common

39
Q

Cholinesterase inhibitors NOT recommended for these dementias

A

Vascular

Frontotemporal (may worsen)

40
Q

These dementias can benefit from cholinesterase inhibitors

A

Lewy body dementia and Parkinson dementia

41
Q

Neuroprotective med that reduces glutamine-mediated excitotoxicity

A

Memantine

42
Q

Mematine has these benefits for AD

A

Benefits cognition, ADLs and behavior in AD

43
Q

SE of memantine

A

Constipation, dizziness, headache

44
Q

Vitamin E effects on AD

A

may lower rate of functional decline

45
Q

Selegiline effect on AD

A

may lower rate of functional decline

46
Q

SE of antidepressants

A

Falls, anticholinergic effects may worsen confusion

47
Q

Is demenitia an inherent part of aging?

A

Nope.

48
Q

Most common type of dementia

A

AD

49
Q

Which is most likely to indicate pathologic neurologic decline?

A

Forgetting to pay mortgage and credit card bills.

50
Q

Which of the following meds should not be used in this patient? Patient w/ hx of frontotemporal dementia that was not reactive to psychoactive meds.

A

Haloperidol

51
Q

What is the risk of prescribing psychotropic meds to patients w/ dementia?

A

First and second generation antipsychotics increase morbidity and all-cause mortality.

Geriatrics Rotation PPTs (19 decks)

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