Dementia and Cognitive Disorders

Question 1

In alzheimers where is the location of the most dense neurofibrillary tangles?

Answer 1

Hippocampus and adjacent structures of the temporal lobe.

Question 2

what does alzheimers show on eeg?

Answer 2

general slowing

Question 3

in diseases which cause dementia which has myoclonus

Answer 3

CJD

Question 4

ventriculoperitoneal shunting puts patient at risk of what post op complication causing patients to become confused with headache

Answer 4

subdural hematoma

Question 5

what kind of aphasia develops in alzheimers

Answer 5

transcortical sensory aphasia

reduced ability to understand complex linguistic structures, repetition is intact

Question 6

pt with acute onset confusion and jumping/easy startling at noises - MRI and CSF show nothing. What comes to mind?

Answer 6

CJD

EEG may show 1-2 Hz periodic sharp waves

Further CSF analysis may show 14-3-3 protein

MRI may show increased T2 in basal ganglia or other gray matter but not always

Question 7

What is Rett syndrome?

Answer 7

presumably X-linked, only affects girls. presents early childhood (~2yo) with rapid regression in cognitive status. Stereotypic hand movements develop (hand wringing). seizure may occur

Question 8

oculomasticatory myorhythmia (pendular convergence of eyes associated with contractions of the masticatory muscles) is pathognomonic for what?

Answer 8

Whipple disease

PAS potitive cells in jejunum

Question 9

Alien hand syndrome is most likely due to what in a pt with hx of drug abuse? (immunocomp)

Answer 9

JC virus –> PML