Dementia

Question 1

Types of dementia

Answer 1

Alzheimer’s, vascular, frontal lobe, subcortical, lewy body

Question 2

What conditions may exist with dementia and may be difficult to distinguish from it?

Answer 2

Depression and delerium

Question 3

What changes in brain occur in AD?

Answer 3

brain weight decreased about 20%, cortical atrophy, neuronal loss and loss of synapses, senile plaques, neurofibrillary tangles, giant ventricles

Question 4

Which test is go-to for AD, and what would it show?

Answer 4

PET- decreased metabolic activity in posterior parietal lobes, then occipital and temporal. In severe cases, frontal lobe also.

Question 5

What NT affected in AD?

Answer 5

ACh decreased. Imbalances also in serotonin, GABA, substance P, NE, and Somatostatin

Question 6

Familial AD is what percent of all cases?

Answer 6

5-10%- in these cases, developed at an earlier age

Question 7

Assessment of AD - signs and sx

Answer 7

MAP GLOBE-J: memory, abnormal movement, personal hygiene, gait, language, orientation, behavior, judgement and problem solving

Question 8

Diagnostic tests for AD

Answer 8

Memory test, memory-orientation-concentration test, time and change test

Question 9

Benefits of neuropsychologic testing in AD

Answer 9

identifies dementia, differentiates between types of dementia, and monitors disease progression

Question 10

What might you see on PE in severe AD?

Answer 10

Flexed gait, myoclonus, tremors. Frontal release signs: snout reflex, root reflex, grasp reflex, and palmar-mental reflex

Question 11

IF suspicious of acute delerium, waht should you do-

Answer 11

refer and hospitalize

Question 12

Causes of delerium

Answer 12

glucose deficiency, dehydration, presence of toxin or accumulation or metabolic waste product like uremia, ketosis

Question 13

AD in postmenopausal women reduced when..

Answer 13

woman is on HRT

Question 14

What is used as preventative therapy in AD

Answer 14

indomethacin and Vitamin E

Question 15

pharmocologic tx of AD

Answer 15

Tacrine (mild to moderate AD), donepazil- anticholinesterase drugs

Question 16

Tx for agitated dementia

Answer 16

neuroleptics

Question 17

Patient with symptoms resembling AD, but also have hallucinations and parkinsonism like movement disorders like rigidity and bradykinesia. Dx?

Answer 17

Lewy body dementia

Question 18

patient with dementia and socially inappropriate behaviors and personality changes. 40-70 years old onset.

Answer 18

Frontal lobe dementia

Question 19

Frontal lobe dementia often misdiagnosed as ..

Answer 19

psychiatric illness or AD

Question 20

What test dto do in vascular dementia

Answer 20

CT or MRI, don’t do PET first

Question 21

subcortical areas of brain affected on MRI. patients motivation, mood, timing, and arousal affected

Answer 21

subcortical dementia

Question 22

What can act like dementia but is not..it impairs language. Patients have trouble expressing what they think and comprehending. Slowly progressive

Answer 22

Primary progressive aphasia

Question 23

what parts of brain affected in primary progressive aphasia

Answer 23

atrophy of frontal and temporal lobes, mostly on left side

Question 24

risk factors for primary progressive aphasia

Answer 24

learning disabilities like dyslexia

Question 25

dx of primary progressive aphasia

Answer 25

neuropsych exam, genetic testing, MRI or PET