Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Neurology > Dementia & Delirium > Flashcards

Dementia & Delirium Flashcards

1
Q

Dementia

A

-impairment of intellectual/cognitive function of sufficient severity to interfere with social or occupational activities

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Delirium

A

-clouding of consciousness (altered clarity of awareness of the environment), with reduced capacity to shift, focus, & sustain attention to environmental stimuli

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Diagnostic Criteria for Dementia?

A
  1. Impaired short and long term memory
  2. at least one of: impaired abstract thinking, impaired judgment, other disturbances (aphasia, apraxia, agnosia)
  3. disturbances in 1 or 2 interferes with work or ADL
  4. symptoms not occurring exclusively during delirium
  5. Either: a) evidence from hx, physical exam or lab of organic cause b) in the absence of evidence for organic cause, exclusion of non-organic mental disorder (depression)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Diagnostic Criteria for Delirium?

A
  1. Disorientation & memory impairment
  2. at least 2: a) perceptual distrubance: misinterpretations, illusions, or hallucinations
    b) speech that is incoherent at times
    c) disturbance of sleep-wake cycel (insomnia or daytime drowsiness)
    d) inc. or dec. psychomotor activity
  3. clinical features that dev. over short period (hrs or days) fluctuate
  4. Evidence from the history, physical exam or lab tests of a spec. organic factor judged to be etiologically related to the disturbance
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Key features of Dementia

A
  • cognitive deficit in multiple domains, usually but not always including memory
  • progressive deterioration over months to years
  • cognitive impairment interferes with activities of daily life
  • no disorder of alertness
  • irreversible
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Key features of Delirium

A
  • acute disorder usually associated with medical illness, drugs, metabolic disorders
  • over days to weeks
  • fluctuating course
  • altered level of consciousness, excitable, delusions, hallucinations
  • reversible
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Depression

A

known onset

  • family is aware
  • short duration
  • history of depression
  • little effort on tasks
  • response to cognit. “don’t know”
  • no cortical signs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Causes of Dementia

A
  • Neurodegenerative Diseases
  • Vascular Dementia
  • Head Trauma
  • Drugs, Toxins, Ethanol
  • Brain Tumors
  • Normal Pressure Hydrocephalus
  • Infections
  • Metabolic Disorders
  • Nutritional (B1, B12, Folate, Niacin deficiencies)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Alzheimer’s Disease

A
  • progressive neurodegenerative dementing disorder characterized by the neuropathological findings of…
    1) loss of cerebral cortical neurons
    2) neuritic plaques containing beta-amyloid
    3) neurofibrillary tangles
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Alzheimer’s Disease Diagnostic Criteria

A
  • Essential: neuropsychological tests, deficits in memory plus one or more areas of cognition, progressive worsening of memory plus one other cognitive function, no disturbances of consciousness, onset b/w 40-90, absence of other brain disease to explain dementia
  • Supportive: progressive deterioration of single cognitive area, impaired activities of daily living, altered behavior, family history of dementia, lab showing normal CSF, nonspecific EEG, & atrophy on CT or MRI
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Consistent Features for Alzheimer’s

A
  • plateaus in course
  • association depression, insomnia, incontinence, delusions
  • non-specific neurological findings later in disease (altered muscle tone, myoclonus, gait ataxia, seizures)
  • CT or MRI “normal for age”
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Inconsistnet Features in Alzheimer’s

A
  • sudden or acute onet
  • focal neurologic findings (hemiparesis)
  • seizures or gait disorder at onset or early in disease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Epidemiology of Alzheimer’s Disease

A

-500,000 new cases in US each year
-5-10% of population >65% and 40-45% >85 will develop Alzheimer’s Disease
~5.4 million people with Alzheimer’s in US
-These numbers are expected to triple over the next 10-20 years as the ‘baby boom’ population enters their 7th and 8th decades

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Clinical Presentation of Alzheimer’s Disease

A
  • insidious onset after age 65 of deficits in recent memory followed by deficits in attention, language, visual-spactial, orientation, abstract thinking, judgment, & eventually personality
  • premorbid diagnosis is purely clinical (no lab tests)
  • postmortem based on neuritic plaques, neurofibrillary tangles, neuron loss
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Alzheimer’s Gross

A

-narrowing of gyri and widening of sulci

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Alzheimer’s Micro

A
  • plaques in cortex

- tangles in hippocampus

17
Q

Alzheimer’s Gene

A 
-Early onset
chromosome 21 APP (AD1) 8 mut (Down's)
Chromosome 14 presenilin 1 (AD3) > 50 mutation
Chromosome 1 presenilin 2 (AD4) 4 mutat.
-late onset
Chromosome 19  Apo E (AD2) 3 alleles
Chromosome 12  a2-Macroglob (AD5) 2 alleles
Chromosome 10
18
Q

Apolipoprotien E

A
  • 3 alleles of APO E (2, 3, 4)
  • participates in cholesterol transport
  • APO E 4 is a risk factor for Alzheimers
  • APO E 4 contributes to 50% of late onset AD
19
Q

Risk Factors for Alzheimer’s Disease

A
  • age, genetics, Down’s syndrome (mongolism)

- education level, mental inactivity, female gender, head injury, hypercholesterolemia, smoking

20
Q

Alzheimer’s: Amyloid Hypothesis

A
  • abnormal processing of amyloid precursor protein with amyloid deposition causes AD
  • autosomal dominant AD caused by inc. Beta-amyloid synthesis
  • late onset AD caused by dec. turnover and aggression of beta-amyloid
  • beta-amyloid deposition precedes clinical symptoms
  • neurofibrillary tangles and neuronal loss occur secondary to beta-amyloid deposition
21
Q

Lewy Bodies

A
  • eosinophilic, spherical inclusions with a halo appearance located in the cytoplasm of neurons of the substantia nigra in patients with Parkinson’s Disease
  • comprise of neurofilament proteins, alpha synuclein, & ubiquitin
  • present with dementia (in neocortex)
  • avoid neuroleptic agents in DLB
22
Q

Frontotemporal Dementias

A
  • degenerations of frontal & temporal lobes
  • Neurofibriallary tangles and or Pick bodies comprised of ubiquitin & hyper-phosphorylated tau protein are the hallmark
  • “tauopathies”
23
Q

Clinical Characteristicts of Pick Disease

A

-uncommon cause of dementia
30-40% are familial with mutation on chromosome 17 for tau protein
-5th decade onset (eariler than AD)
-progressive loss of judgment with disinhibtion, social misconduct, or withdrawal out of proportion with the degree of anterograde amnesia
-progressive loss of language aut of proportion to the degree of anerograde amnesia

24
Q

Pick Gross/Micro

A
  • atrophy in frontal lobe and tip of temporal lobe
  • “knife like” gyri
  • Pick Bodies
  • Intracytoplasmic, argyrophilic inclusions of 14nm straight filaments and 22nm twisted filaments comprised of tau protein & ubiuitin
25
Q

Frontotemporal Dementias: Anatomic/Symptom Correlation

A

-Frontal Lobe Symptoms
disinhibited, socially inappr., impulsive, compulsive, hyperphagic/oral, hypo/hyper sexual, nonfluent aphasia
-Temproal Lobe
fluent (sematic) aphasia, emotionally flat, apathetic

26
Q

Vascular Dementia: Characteristicts

A
  • 2nd most common cause of dementia death
  • multiple infarctions involving large or small vessels
  • multiple distribution of infarcted brain
  • high incidence in untreated or poorly treated HTN
  • considerable overlap with Alzherimer’s Disease in the >65 age group
27
Q

Workup for Dementia

A
  • Folstein Mini-Mental Status Examine

- total 30, <27 raise concern

Neurology (18 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions