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Neuro/Psych Exam > Dementia and Alzheimers > Flashcards

Dementia and Alzheimers Flashcards

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1
Q

What is the prevalence of Alzheimer’s?

A

1/3 over 80

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2
Q

Describe the prognosis of Alzheimers

A

10 years from diagnosis to death; faster progression if diagnosed at older age

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3
Q

Which type of memory is affected more in Alzheimers?

A

Short Term

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4
Q

In addition to memory loss what are other sxs of Alzheimers?

A
  1. Problems with words in speaking and writing
  2. Trouble with spatial relationships
  3. Difficulty in problem solving
  4. Personality Changes
  5. Misplacing things
  6. Poor judgement
  7. Social isolation
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5
Q

Late stage symptoms of Alzheimers include what?

A
  1. Cannot communicate
  2. Incontinence
  3. Cannot feed/dress
  4. Cannot recognize family
  5. Cannot walk
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6
Q

Describe the pathology of Alzheimers

A
  1. Beta Amyloid Plaques develop slowly, long before symptoms
  2. NF Tangles and synaptic loss accelerate and occur at onset of symptoms
  3. Neuronal Loss
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7
Q

Mild cognitive impairment occurs when compared to the onset of AD symptoms?

A

5 years

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8
Q

Which neurocognitive disorder presents as a stepwise deterioration?

A

Vascular Type

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9
Q

What is the CT finding of Vascular Dementia?

A

White areas outside of the ventricles

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10
Q

Which dementia presents with visual hallucinations and frequent falls?

A

Lewy Body Dementia

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11
Q

What is the pathologic finding in Lewy Body Dementia?

A

Accumulations of Alpha Synuclein

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12
Q

What are Pick Bodies?

A

Abnormal accumulations of too much Tau

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13
Q

What demographic is affected by Pick’s (Frontotemporal) Dementia?

A

Younger Age

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14
Q

Which type of dementia presents with behavioral changes, especially in emotional and language (ex- nursing home patient becomes hypersexual)?

A

Pick’s (Frontotemporal) Dementia

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15
Q

Which type of dementia presents as wet, wacky and wobbly?

A

Normal Pressure Hydrocephalus

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16
Q

What may reverse the sxs of Normal Pressure Hydrocephalus?

A

A shunt

17
Q

What are other potential causes of Neurocognitive disorders?

A
  1. Infection (HIV, CJ, Syphilis)
  2. Deficiencies (B12 or Hypothyroidism)
  3. Chronic Alcohol
18
Q

What lab studies should be done for dementia?

A
  1. CBC
  2. CCP
  3. B12
  4. TSH
  5. Head CT without Contrast
19
Q

What are genetic risks for early onset Alzheimers?

A
  1. APP (21)
  2. Presenilin 1 (14)
  3. Presenilin 2 (1)
20
Q

What is a genetic risk for Alzheimers that increases the risk based on the number of copies of the allele the patients get?

A

APOE gene (4)

21
Q

What are risk factors for Alzheimers?

A
  1. HTN
  2. Diabetes
  3. Hypercholesterolemia
  4. Smoking
22
Q

What are potential drugs for Alzheimers?

A
  1. Donepezil
  2. Rivastigmine
  3. Galantamine
    (All AchE Inhibitors)
23
Q

What is a drug given for the late stage of Alzheimers that blocks NMDA receptors in the Glutamate pathway?

A

Memantine

24
Q

What are the symptoms of delirium?

A
  1. Inattention
  2. Acute onset
  3. Disorientation/Altered consciousness
  4. Disorganized thinking
  5. No pre-existing problem or medical cause
25
Q

What are risk factors for Delirium?

A
  1. Male
  2. Older than 65
  3. Depression or Terminal Illness
  4. Polypharmacy
  5. Lack of physical activity
  6. Alcohol Abuse
  7. Vision and Hearing Loss
26
Q

What causes Delirium?

A 
Drugs
Electrolyte/Encodrine 
Lack of Drugs (withdrawal)
Infection (UTI, pneumonia)
Reduced Sensory Input 
Intracranial Infection, Hemorrhage, Stroke or tumor
Urinary/fecal retention
Major Organ Issue (MI, COPD, renal/hepatic failure)
27
Q

What type of surgery increases a patients risk for getting delirium?

A
  1. Orthopedic
  2. Thoracic
  3. Abdominal Aortic Aneurysm Repair
28
Q

Why do surgeries cause delirium?

A

Blood loss

29
Q

What are the first labs you should do for delirium?

A
  1. CBC
  2. Chem/electrolytes
  3. BUN/Creatinine
30
Q

What are secondary tests you can order for delirium?

A
  1. Chest X Ray
  2. UA or culture
  3. Head CT
  4. UTS
31
Q

How to prevent delirium?

A
  1. Reorient the patient (news)
  2. Minimize sleep deprivation
  3. Walk
  4. Water, food and Oxygen
  5. Treat pain
  6. Hearing Aids and Glasses
  7. Do not use restraints and minimize catheters
  8. Prevent constipation
32
Q

When is medication used for delirium?

A

Haloperidol or atypicals (risperidone, olanzapine and quetiapine) may be given if SEVERE agitation only

33
Q

Would would the secondary treatment be for delirium?

A

Benzodiazepines

Neuro/Psych Exam (12 decks)

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