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neurology > dementia/CP > Flashcards

dementia/CP Flashcards

1
Q

Dementia definition and progression

A

Loss of the ability to problem solve significant enough to affect the patient’s activities of daily living
Chronic slowly progressive loss of function

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2
Q

Alzheimer’s Disease is the most common cause making up about 75% of all dementias
Brain injury
Lewy body dementia
Vascular dementia

A

Non reversible causes of dementia

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3
Q

Alzheimer’s Disease is what % of all dementias

A

75%

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4
Q 
Hypothyroidism
Vitamin B12 deficiency
Lyme disease
Neurosyphilis
Hydrocephalus
A

Reversible causes of dementia

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5
Q

dementia is 2 out of what spheres

A

language, memory, visuospatial skills, emotional behavior, personality, cognition

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6
Q

most significant risk factor for alzheimers

3 other factors

A

old age

other: FH, education level, female

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7
Q

alzheimers prevelance

A

doubles every 5 years in the older population.

reaching 30%-50% at age 85 yrs

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8
Q

what chromosomes for alzheimers

A

1, 14, 19, 21

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9
Q

alzheimers tx

A 
Psychological Therapies
Medication
Acetylcholinesterase inhibitors – Donepezil(improve memory function and delay d/s progression)
Antipsychotic drugs
Antidepressants
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10
Q

improve memory function and delay d/s progression

A

Acetylcholinesterase inhibitors – Donepezil

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11
Q

multi-infarct dementia

  • gender
  • assoc with what
A

men

HTN with or w/out hx of TIA or stroke

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12
Q

vascular dementia symptoms

A

forgetfulness in the absence of depression and inattentiveness

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13
Q

speech difficulty, trouble performing routine tasks, sensory interpretation difficulty, confusion, amnesia, executive dysfunction

A

cortical symptoms of vascular dementia

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14
Q

gait problems, urinary difficulties, motor deficits, personality changes

A

subcortical symptoms of vascular dementia

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15
Q

syndrome secondary to degeneration of the frontal lobe and may include the temporal lobe

A

frontotemporal dementia

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16
Q

frontal lobe symptoms

A

behavioral- euphoria, apathy, dishibition; and

compulsive disorders

17
Q

frontal release signs

A

palmomental, palmar grasp, rooting reflexes

18
Q

MRI of frontotemporal dementia

A

atrophy to lobe in late cases

19
Q

what other test for frontotemporal dementia

A

PET: show hypometabolism- to differentiate alzheimer from biparietal hypometabolism

20
Q

seen with psychiatric illness who appear to be demented; seen with what illness

A

pseudodementia; seen with major depressive episode

21
Q

complain of memory problems but attention span and concentration appear intact while appearing upset or distressed

A

pseudodementia

22
Q

in true dementia… you see what

A

pt will often give wrong answers, have poor attention and concentration, and appear indifferent or unconcerned

23
Q

pseudodementia tx

A

antidepressant with SSRI first line; no acetylcholinesterase inhibitors

24
Q 
Change in mental status
Seizures
Loss of bowel or bladder function
Poor Balance
Falling
Difficulty walking
Fainting
Lightheadedness
Weakness in the face, arms and legs
A

altered level of consciousness

25
Q 
Levels of consciousness
Conscious 
Confused 
Delirious 
Somnolent 
Obtunded 
Stuporous 
Comatose
A

Levels of consciousness
Conscious – Normal
Confused – Disoriented / Impaired
Delirious – Disoriented, restless, hallucinations, and delusions may occur
Somnolent – Sleepy
Obtunded – Decreased alertness and slowed response
Stuporous –Respond only to severe pain
Comatose – Non-arousable, Non-responsive to stimuli

26
Q

Levels of consciousness
– Normal
– Disoriented / Impaired
– Disoriented, restless, hallucinations, and delusions may occur
– Sleepy
– Decreased alertness and slowed response
–Respond only to severe pain
– Non-arousable, Non-responsive to stimuli

A

Levels of consciousness
Conscious – Normal
Confused – Disoriented / Impaired
Delirious – Disoriented, restless, hallucinations, and delusions may occur
Somnolent – Sleepy
Obtunded – Decreased alertness and slowed response
Stuporous –Respond only to severe pain
Comatose – Non-arousable, Non-responsive to stimuli

27
Q

altered level of consciousness tx

A

Maintain patent airway and monitor circulatory status
Medications
Dextrose – for hypoglycemia
Naloxone
Thiamine
Lumbar puncture – if meningitis is suspected

28
Q

Cerebral Palsy

  • progressive?
  • Evident when?
A

Cerebral Palsy
Things you should know
Lifelong physical disability due to damage of the developing brain. This is not progressive.
Evident in the first 12 to 18 months

29
Q
  • Risk Factors 4 CP
A

About 50% of CP patients are born premature
Low birth weight
Infection of the mother in early pregnancy
Prolonged loss of oxygen during the pregnancy or birthing process

30
Q

Musculoskeletal CP

  • muscle tone and control
  • unable to hold what up
  • 75% have what
  • walk when
  • talk when
  • reflexs
A

Low muscle tone
Unable to hold head up
75% of patients present with spasticity and contractures. This is often found on one side of the body.
Poor muscle control
Unable to walk at 12 to 18 month
Language delay – Inability to speak simple sentences by 24 months
hyporeflexia

31
Q 
Physical Exam:
Slow motor movement
Tight or floppy muscle tone
Contractures & spasticity
Missed developmental milestones
CT or MRI – may show what?
A

CP

32
Q

CP in pregnancy

A

Preventative measures
Carry baby to term
Magnesium Sulphate – Is used to help prevent preterm labor

33
Q

Medical treatment CP

A

Benzodiazepines -help with muscle spasms
Diazepam
Botulinum toxin type A injection – administered IM for muscles with spasticity
Antiepileptic medication – to minimize seizures

34
Q

surgery for CP

A

Fasciotomy
Muscle lengthening
Joint replacement

35
Q

What is the #1 risk factor for a child having CP?

A

Prematurity

neurology (10 decks)

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