dementia + delerium Flashcards

1
Q

memory loss +

cognitive dysfunction: executive function, decision-making, language, personality

A

dementia

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2
Q
loss of neurons in:
prefrontal cortex (executive function, personality)
temporal lobe (hippocampus - memory)
A

dementia

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3
Q

most common causes of dementia

A

1) Alzheimer’s disease
2) vascular dementia
3) Lewy body dementia

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4
Q

INTRACELLULAR tau protein: neurofibrillary tangles

EXTRACELLULAR beta-amyloid: senile plaques (amyloid plaques)

A

Alzheimer’s disease

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5
Q

genetic form of dementia associated with abnormal proteins:
presenilin 1
presenilin 2
amyloid precursor protein (APP): APP gene on chrom 21

A

early-onset Alzheimer disease

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6
Q

down syndrome has increased risk of

A

early-onset Alzheimer disease

extra copy of chrom 21: extra copy of amyloid precursor protein gene (APP gene)

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7
Q
dementia associated with abnormal protein:
apoE4 apolipoprotein (chaperone protein helps to induce B sheet formation)
A

late-onset Alzheimer disease

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8
Q

treatment of Alzheimer disease will slow down progression of disease

A

1) cholinesterase inhibitors (donepezil, galantamine, rivastigmine): ↑ Ach
2) NMDA antagonist (memantine): glutamate receptor → excitotoxicity (form of neurotoxicity)

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9
Q

dementia associated with:
overstimulated NMDA receptor (glutamate R) +
↓ Ach

A

Alzheimer disease

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10
Q

dementia evaluation

A

1) RPR (syphilis)
2) HIV (MI encephalopathy)
3) vitamin B12 deficiency (reversible)
4) low TSH
5) MRI of brain (normal pressure hydrocephalus is reversible, vascular dementia - microinfarctions = ischemic changes in white matter)
6) copper (wilson’s disease)
7) depression in elderly (“pseudodementia” - if true dementia pt doesn’t recognize problem, if aware of memory loss not dementia)
8) CBC, BMP

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11
Q

eosinophilic cytoplasmic inclusions that contain α synuclein

A

seen in:
Parkinson disease
Lewy Body dementia (in neurons of cortex)

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12
Q

parkinsonian features begins >1 year before dementia

A

Parkinson disease

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13
Q

dementia +/- co-current parkinsonian features (resting tremor, bradykinesia) or parkinsonian features occur

A

Lewy Body dementia

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14
Q

INTRACELLULAR inclusions of tau protein (pick bodies)
atrophy of frontal + temporal lobes
initial sx: behavior/personality change (frontal lobe) or progressive aphasia (difficulty expressing self or understanding others) → dementia

A

frontotemporal dementia (Pick disease)

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15
Q

rapidly progressive dementia (wks-mo)
personality changes
myoclonus (muscle spasm)

A

creutzfeldt-jacob disease

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16
Q

prion disease causing dementia
transmissible, infectious protein particles (misfolded protein) serving as template for host proteins → induce conformational change in host cells (misfolding of host proteins) → induce formation of B pleated sheets → neuronal death → vacuoles in brain (sponge)

A

creutzfeldt-jacob disease “spongioform encephalopathy” or “mad cow disease”

17
Q

dementia
ataxia
loss of pupillary light reflex

A

3° syphilis

18
Q

dementia + megaloblastic anemia + peripheral neuropathy

A

vitamin B12 deficiency

19
Q

dementia + urinary incontinence + magnetic gait

A

normal pressure hydrocephalus
Wet
Wacky
Wabbly

20
Q

dementia + syncopal episodes

A

lewy body dementia

21
Q

dementia + dysarthria + liver disease

A

Wilson disease

22
Q

dementia + myoclonus

A

creutzfeldt-jakob disease

23
Q
fluctuating level of consciousness (waxes/wanes)
ACUTE onset (hrs -days)
disturbance in sleep-wake cycle (difficult to arouse during day, up all night)
rapid ↓ attention span
↓ level of arousal
acute change
acute changes in mental status
disorganized thinking
visual hallucinations
usually reversible (not dementia)
A

delerium

24
Q

most common causes of delerium - delerium evaluation

A

drugs: BZD, drugs with anticholinergic drugs (mad as hatter - avoid if elderly, may highlight underlying dementia)
UTI

25
Q

orientation to:
person
place
time

A

order of loss:
time
place
person (self is last)