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Neurology > Dementia and Delirium > Flashcards

Dementia and Delirium Flashcards

1
Q

disorder that is characterized by a decline in cognition involving one or more cognitive domains

A

dementia

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2
Q

most common form of dementia

A

alzheimer’s (60-80%)

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3
Q

How many areas of cognition need to be impaired for diagnosis of Alzheimer’s?

A

two

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4
Q

Earliest sign of Alzheimer’s

A

short-term memory loss

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5
Q

MRI finding that suggests AD

A

bilateral hippocampal atrophy

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6
Q

Scoring assessment of mini-mental status exam (MMSE)

A

20-26: mild functional dependence. 10-20: moderate dependence. Score < 10: severe, total dependence

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7
Q

Neuropathological hallmarks of AD

A

Amyloid-rich senile plaques, Neurofibrillary tangles, Neuronal degeneration

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8
Q

most common functioning deficit for patient’s at stage 4 of AD

A

decreased ability to manage instrumental (complex) activities of daily life.

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9
Q

characteristic functional change of stage 5 of AD

A

deficits in basic activities of daily life and can’t recall major events

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10
Q

characteristic function changes of stage 6 of AD

A

cannot perform basic activities without help and cannot live at home without assistance. lasts 2.5 yrs

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11
Q

characteristic function changes of stage 7 of AD

A

inability to speak, walk, or sit up on their own. lasts 1 yr

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12
Q

most frequent cause of death of AD

A

aspiration pneumonia

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13
Q

MOA of cholinesterase inhibitors

A

curb the breakdown of acetylcholine

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14
Q

What is the only tx approved by FDA for all stages of Alzheimer’s?

A

Donepezil (Aricept)

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15
Q

Cholinesterase Inhibitors

A

Donepezil (Aricept), Rivastigmine (Exelon)‏, Galantamine (Reminyl)/Razadyne

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16
Q

Cholinesterase inhibitor CI with severe renal or hepatic impairment

A

Galantamine (Reminyl)/Razadyne

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17
Q

MOA of NMDA receptor antagonists

A

protective role in the brain by regulating the activity of a glutamate.

18
Q

NMDA receptor antagonists

A

Memantine (Namenda)‏

19
Q

Supplement that may be helpful with Alzheimers due to antioxidant properties

A

vitamin E

20
Q

SSRIs recommended for AD to treat depression or behavioral sx

A

sertraline (Zoloft), Paroxetine (Paxil), Citalopram (Celexa)

21
Q

Anxiolytics helpful for anxiety, restlessness, verbally disruptive behavior and resistance in AD

A

lorazepam (Ativan) and oxazepam (Serax)

22
Q

Pattern of deterioration associated with vascular dementia compared to AD

A

vascular is abrut, fluctuating or stepwise deterioration whereas AD is progressive

23
Q

Characterized by focal atrophy of the frontal and temporal lobes

A

frontotemporal dementia

24
Q

Characterized pathologically by the presence of Pick bodies in the neocortex and hippocampus.

A

Pick’s disease (subtype of FTD)

25
Q

Onset of FTD

A

35-75 yrs

26
Q

A condition of pathologically enlarged ventricular size with normal opening pressures on lumbar puncture

A

Normal-Pressure Hydrocephalus

27
Q

Triad of Normal-Pressure Hydrocephalus

A

dementia, gait disturbance, and urinary incontinence

28
Q

TX of normal-pressure hydrocephalus

A

placement of a ventriculoperitoneal shunt

29
Q

Miller Fisher Test used to assess for normal pressure hydrocephalus

A

objective gait assessment before and after removal of 30 cc CSF. Will improve after removal of CSF

30
Q

dementia accompanied by delirium, visual hallucinations, and parkinsonism

A

Dementia with Lewy Bodies

31
Q

cardinal motor features of parkinson’s

A

bradyakinesia, rigidity, resting tremor, postural instability

32
Q

How do you differentiate between parkinson’s dementia and DLB?

A

Dementia typically occurs in the last half of the clinical course of PD, whereas it is often one of the presenting features of DLB

33
Q

Restricted up-and-down eye movement (vertical gaze palsy) is a hallmark of this disease

A

Progressive supranuclear palsy (aka Steele Richardson Olszewski syndrome)

34
Q

How do you differentiate between progressive supranuclear palsy and Parkinson’s?

A

Patients with PSP stand straight or occasionally even tilt their heads backward, while those with Parkinson’s disease usually bend forward

35
Q

Etiology of Creutzfeldt-Jacob Disease (aka mad cow)

A

prion contracted by consuming mat’l from infected animals

36
Q

Infections that can cause dementia

A

syphilis and HIV

37
Q

medications associated with torsades de pointes and sudden death due to lengthened QT interval

A

haloperidol and inapsine

38
Q

Treatment of choice for delirium due to benzodiazepine or alcohol withdrawal

A

benzos

39
Q

Percent of patients with delirium who die within 6 months

A

25%

40
Q

Characteristics of delirium that differ from dementia

A

acute, reversible, attn impaired, range of LOC from lethargic to hyperalert, varied effect on memory

Neurology (16 decks)

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