Dementia

Question 1

dementia

Answer 1

aquired syndrome of decline in memory and other cognitive functions in an alert patient that alters ADLS

Question 2

basic ADL’s

Answer 2

basic biological and self-care tasks

Question 3

instrumental ADL’s

Answer 3

allows for independent living in a community

Question 4

four cognitive domains

Answer 4

recent memory
executive function
visuospatial ability
language

Question 5

recent memory

Answer 5

ability to learn and recall new info

Question 6

language

Answer 6

either comphrension or expression

Question 7

visuospatial ability

Answer 7

comphrension and effective manipulation of nonverbal, graphic or geographic

Question 8

executive function

Answer 8

ability to plan, preform abstract reasoning, solve problems, focus despite distractions and shift focus when appropriate

Question 9

Mini-cog test

Answer 9

3-minute screening tool for cognitive impairment

- 3 item recall and clock draw

Question 10

what must happen before diagnosing dementia

Answer 10

rule out metabolic causes

toxicology, ammonia level

Question 11

when should brain imaging be considered?

Answer 11

• when normal pressure hydrocephalus is suspected
• recent fall or head trauma
• onset less than 65
• focal or asymetric symptoms

Question 12

normal-pressure hydrocephalus

Answer 12

dilated brain ventricles with normal CSF pressure

-ataxia and urinary incontinece

Question 13

mild cognitive impairment

Answer 13

• subjective complaint of decline in at least i cognitive domain
• noticeable and measurable

Question 14

prognosis of mild cognitive impairment

Answer 14

50% remain stable or go back to normal in 3-5 years

50% with depression as well–> dementia within 5 years

Question 15

distinguishing signs of delirium

Answer 15

• acute onset
• fluctuations in cognition over hours to days
• impaired consciousness and attention
• altered sleep cycles

Question 16

insomnia is…

Answer 16

a result of dementia

a cause of delirium

Question 17

distinguishing signs of depression

Answer 17

• low motivation during cognitive testing
• complaints exceed deficits
• maintain language and motor skills

Question 18

onset and progression of Alzheimers disease

Answer 18

gradual and progressive

Question 19

cognitive symptoms in Alzheimers disease

Answer 19

memory impairment is the earliest feature and core

Question 20

when are motor and sensory symptoms seen in alzheimers disease

Answer 20

very late

- apraxia, aphasia, viso-spatial

Question 21

risk factors for Alzheimers disease

Answer 21

age and family history

Question 22

onset and progression of Vascular dementia

Answer 22

sudden or gradual

stepwise with further ischemia

Question 23

abnormalities seen on imagining Alzheimers disease

Answer 23

global atrophy, small hippocampal volumes

Question 24

abnormalities seen on imaging vascular dementia

Answer 24

cortical or subcortical ischmic changes/infarts on MRI

Question 25

prevalence of Lewy body dementia

Answer 25

second most common cause of dementia

Question 26

onset and progression of Lewy body dementia

Answer 26

gradual onset/progression but faster than AD

Question 27

diagnosis of Lewy body dementia

Answer 27

dementia and at least 2.. 1. visual hallucinations (well detailed) 2. parkinsonian signs 3. fluctuating alertness or attention

Question 28

memory impairment in Lewy body dementia

Answer 28

not as pronounced as deficits in other cognitive domains

Question 29

abnormalities seen on imagine in Lewy body dementia

Answer 29

possible global atrophy

Question 30

how does location of lewy bodies affect patient manifestation?

Answer 30

at base of brain (problems with movement and autonomics)-parkinsons in outer layers of the brain linked to cognitive symptoms- LB dementia

Question 31

onset and progression of frontotemporal dementia

Answer 31

usually age less than 60 | gradual but faster than AD

Question 32

distinguishing signs of frontotemporal dementia

Answer 32

- disinhibition, social impropriety - hyperorality - compulsiveness

Question 33

possible abnormalities seen on imaging in frontotemporal dementia

Answer 33

atrophy in frontal and temporal lobes

Question 34

triad of normal pressure hydrocephalus

Answer 34

dementia ataxia urinary incontience

Question 35

diagnosis is parkinsons with dementia if...

Answer 35

parkinsons disease has been present for greater than a year before cognitive symptoms are seen

Question 36

diagnosis is lewy body dementia if...

Answer 36

parkinsonian symptoms present less than 1 year, at the same time, or after the onset of cognitive symptoms

Question 37

how to distinguish AD from parkinsons with dementia

Answer 37

AD no tremor

Question 38

distinguishing characteristics of huntingtons dementia

Answer 38

choreiform movement no tremor congnitive impairment occurs late

Question 39

proteins found in huntingtons dementia

Answer 39

huntingtin protein

Question 40

proteins found in AD

Answer 40

- tau pro neurofibrillary tangles - ubiquilin-1 - amyloid plaques

Question 41

proteins found in Lewy body and parkinsons dementia

Answer 41

cytoplasmic a-synuclein inclusion bodies

Question 42

proteins found in fronto-temporal dementia

Answer 42

tau or ubiquilin-2

Question 43

nonpharm management

Answer 43

physical activity education and support orientation and memory aids

Question 44

pharmacological management

Answer 44

- cholinesterase inhibitors - NMDA receptor antagonists - antidepressants - physcoactive meds