Dementia and Delerium

Question 1

Used up until the 19th century to mean various forms of mental derangement

-But, identified specifically with old age as early as the 1st or 2nd century CE by the poet Juvenal

Answer 1

Dementia

Question 2

Used for both delusions and brain diseases (phrenitis) through the 19th century

Answer 2

Delerium

Question 3

Two words to describe a break-down (failure) in brain function

Answer 3

Dementia and Delirium

Question 4

A general term denoting the patient’s incapacity to think with customary speed, clarity, and coherence

Answer 4

Acute Confusional State

Question 5

Its most conspicuous attributes are impaired attention and power of concentration, disorientation—which may be manifest or is demonstrated only by direct questioning, an inability to properly register immediate events and to recall them later, a diminution of all mental activity, including the normally constant inner ideation and sometimes by the appearance of bewilderment

Answer 5

Acute confusional state

Question 6

Where “agitation, hallucinations, and sometimes convulsions and tremor accompany the core confusional state.”

Answer 6

Delerium

Question 7

A disturbance in attention (i.e., reduced ability to direct, focus, sustain, and shift attention) and awareness (reduced orientation to the environment)

Answer 7

Delerium

Question 8

The disturbance develops over a short period of time (usually hours to a few days), represents a change from baseline attention and awareness, and tends to fluctuate in severity during the course of a day

Answer 8

Delerium

Question 9

DSM-5 classifies delirium as an additional disturbance in

Answer 9

Cognition

Question 10

Delerium is a disturbance of

Answer 10

Arousal and/or attention

Question 11

Subjective decline in functioning from baseline not normal for age affecting one or more cognitive domains

Answer 11

Mild Cognitive Impairment

Question 12

Mild Cognitive Impairment is NOT associated with significant

Answer 12

Funcitonal Impairment

Question 13

An acquired disturbance in cognition without impairment in daily functioning

Answer 13

Mild Cognitive Impairment (MCI)

Question 14

Approximately what percentage of ED patients are delerious on presentation?

Answer 14

10-16%

Question 15

Delerium patients over 65 have a 12 month mortality rate of?

Answer 15

40%

Question 16

Failure of the cells of the brain to function appropriately generally due to failure in cerebral metabolism

Answer 16

Delirium

Question 17

Failure in availability or distribution of necessary fuels for metabolism (i.e Glucose, Water, and Oxygen)

Answer 17

Failure of Cerebral Metabolism

Question 18

Look for PE findings that might point to a particular etiology. For instance: asterixis and myoclonus for

Answer 18

Hepatic encephalopathy

Question 19

Look for PE findings that might point to a particular etiology. For instance: Wide pupils, lack of sweating, increased HR, mumbling and picking for

Answer 19

Anticholinergic Delerium

Question 20

A medical emergency (i.e. acute brian failure) that requires urgent medical care

Answer 20

Delirium

Question 21

Preferred over benzodiazepines and anticholinergics for agitation

Answer 21

Neuroepileptics

Question 22

Females are at a higher risk than males for

Answer 22

Dementia

Question 23

Decreased daily exercise or physical activities and decreased mental stimulation are risk factors for

Answer 23

Dementia

Question 24

Mainly functional, metabolic, infectious, or paraneoplastic/autoimmune causes

Answer 24

Reversible dementia

Question 25

Mainly due to structural lesions

Answer 25

Arrestable but non-reversible dementia

Question 26

What are the two types of cognitive enhancer medications?

Answer 26

Acetylcholinesterase inhibitors and NMDA receptor antagonists

Question 27

What are the three acetylcholinesterase inhibitors?

Answer 27

Donepazil, Rivastigmine, and Galantamine

Question 28

What is an example of an NMDA receptor antagonist?

Answer 28

Mementine

Question 29

Acute brain failute

Answer 29

Delirium

Question 30

Chronic brain failure

Answer 30

Dementia

Question 31

Cause an atypical Alzheimer’s syndrome

Answer 31

Lewy bodies

Question 32

Has the clinical characteristics of prominent motor symptoms (Parkinsonism) and behavioral symptoms (Visual Hallucinations and altered sensorium) early on

Answer 32

Lewy Body Dementia (LBD)

Question 33

Memory difficulties and language dysfunction are usually less severe then AD early in the disease. Relatively more visuo-spatial, attention, and executive dysfunction early compared to AD

Answer 33

LBD

Question 34

100% fatal. More rapid mortality and more functional difficulties relative to AD

Answer 34

LBD

Question 35

Deficits characterized by a loss of cholinergic neurons in the nucleus basalis of Meynert, decreased cortical choline acetyltransferase, and depletion of dopaminecontaining neurons

Answer 35

Lewy Body Dementia

Question 36

The main difference between LBD and PD is whether the dementia comes

Answer 36

Early (within 1st year) or later

Question 37

A dementia syndrome with prominent behavioral symptoms, featuring characteristic patterns of atrophy and later confirmed by Alzheimer to have an absence of plaques and tangles

Answer 37

Frontotemporal Dementia (Pick’s Disease)

Question 38

Characterized by left frontal degeneration and the development of primary language problems before rpogressing into a more typical dementia pattern

Answer 38

Primary Progressive Aphasia

Question 39

Characterised by anterior temporal atrophy and primary language and memory problems that differ from Mesulam’s PPA and typical AD

Answer 39

Semantic Dementia (SD)

Question 40

The primary deficit in SD is

Answer 40

Semantic knowledge

Question 41

Third most common degenerative dementia after AD and DLB

-Accounts for nearly 5-10% of all dementia

Answer 41

Frontotemporal Dementia (FTD)

Question 42

As common or more common than AD in patients in the 45-65 age group. Usually occurs at ages less then 65

Answer 42

FTD

Question 43

Varying degrees of argyrophilic Pick Bodies, Astrocytic plaques, Cytoplasmic inclusions, and Ballooned Neurons, depending on subtype

Answer 43

FTD

Question 44

Most cases of FTLD present with protein accumulations involving either:

Answer 44

TDP-43, Tau, or FUS

Question 45

40% of FTLD cases have a genetic heritability pattern with 10% being

Answer 45

Autosomal Dominant

Question 46

Mutations to microtubual-associated protein tau (MAPT) on chromosome 17 causes autosomal dominant syndrome called “FTDP-17” cause accumulations of

Answer 46

Tau

Question 47

Mutations to the Progranulin gene (PGRN) on chromosome 17 and C9orf72 on chromosome 9 have the highest association cause accumulation of

Answer 47

TDP-43

Question 48

Mutations to the FUS gene on chromosome 16 cause the accumulation of

Answer 48

FUS