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Clin Med-Neuro > Dementia > Flashcards

Dementia Flashcards

1
Q

dementia

A

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

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2
Q

basic ADL’s

A

basic biological and self-care tasks

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3
Q

instrumental ADL’s

A

allows for independent living in a community

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4
Q

four cognitive domains

A

recent memory
executive function
visuospatial ability
language

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5
Q

recent memory

A

ability to learn and recall new info

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6
Q

language

A

either comphrension or expression

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7
Q

visuospatial ability

A

comphrension and effective manipulation of nonverbal, graphic or geographic

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8
Q

executive function

A

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

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9
Q

Mini-cog test

A

3-minute screening tool for cognitive impairment

- 3 item recall and clock draw

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10
Q

what must happen before diagnosing dementia

A

rule out metabolic causes

toxicology, ammonia level

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11
Q

when should brain imaging be considered?

A
  • when normal pressure hydrocephalus is suspected
  • recent fall or head trauma
  • onset less than 65
  • focal or asymetric symptoms
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12
Q

normal-pressure hydrocephalus

A

dilated brain ventricles with normal CSF pressure

-ataxia and urinary incontinece

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13
Q

mild cognitive impairment

A
  • subjective complaint of decline in at least i cognitive domain
  • noticeable and measurable
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14
Q

prognosis of mild cognitive impairment

A

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

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

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15
Q

distinguishing signs of delirium

A
  • acute onset
  • fluctuations in cognition over hours to days
  • impaired consciousness and attention
  • altered sleep cycles
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16
Q

insomnia is…

A

a result of dementia

a cause of delirium

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17
Q

distinguishing signs of depression

A
  • low motivation during cognitive testing
  • complaints exceed deficits
  • maintain language and motor skills
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18
Q

onset and progression of Alzheimers disease

A

gradual and progressive

19
Q

cognitive symptoms in Alzheimers disease

A

memory impairment is the earliest feature and core

20
Q

when are motor and sensory symptoms seen in alzheimers disease

A

very late

- apraxia, aphasia, viso-spatial

21
Q

risk factors for Alzheimers disease

A

age and family history

22
Q

onset and progression of Vascular dementia

A

sudden or gradual

stepwise with further ischemia

23
Q

abnormalities seen on imagining Alzheimers disease

A

global atrophy, small hippocampal volumes

24
Q

abnormalities seen on imaging vascular dementia

A

cortical or subcortical ischmic changes/infarts on MRI

25
Q

prevalence of Lewy body dementia

A

second most common cause of dementia

26
Q

onset and progression of Lewy body dementia

A

gradual onset/progression but faster than AD

27
Q

diagnosis of Lewy body dementia

A

dementia and at least 2..

  1. visual hallucinations (well detailed)
  2. parkinsonian signs
  3. fluctuating alertness or attention
28
Q

memory impairment in Lewy body dementia

A

not as pronounced as deficits in other cognitive domains

29
Q

abnormalities seen on imagine in Lewy body dementia

A

possible global atrophy

30
Q

how does location of lewy bodies affect patient manifestation?

A

at base of brain (problems with movement and autonomics)-parkinsons

in outer layers of the brain linked to cognitive symptoms- LB dementia

31
Q

onset and progression of frontotemporal dementia

A

usually age less than 60

gradual but faster than AD

32
Q

distinguishing signs of frontotemporal dementia

A
  • disinhibition, social impropriety
  • hyperorality
  • compulsiveness
33
Q

possible abnormalities seen on imaging in frontotemporal dementia

A

atrophy in frontal and temporal lobes

34
Q

triad of normal pressure hydrocephalus

A

dementia
ataxia
urinary incontience

35
Q

diagnosis is parkinsons with dementia if…

A

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

36
Q

diagnosis is lewy body dementia if…

A

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

37
Q

how to distinguish AD from parkinsons with dementia

A

AD no tremor

38
Q

distinguishing characteristics of huntingtons dementia

A

choreiform movement
no tremor
congnitive impairment occurs late

39
Q

proteins found in huntingtons dementia

A

huntingtin protein

40
Q

proteins found in AD

A
  • tau pro neurofibrillary tangles
  • ubiquilin-1
  • amyloid plaques
41
Q

proteins found in Lewy body and parkinsons dementia

A

cytoplasmic a-synuclein inclusion bodies

42
Q

proteins found in fronto-temporal dementia

A

tau or ubiquilin-2

43
Q

nonpharm management

A

physical activity
education and support
orientation and memory aids

44
Q

pharmacological management

A
  • cholinesterase inhibitors
  • NMDA receptor antagonists
  • antidepressants
  • physcoactive meds

Clin Med-Neuro (8 decks)

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