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Clin Med- Neuro > Dementia/Delirium Lecture > Flashcards

Dementia/Delirium Lecture Flashcards

1
Q

An acute confusional state with decreased attention

*usually lasts hours to days
*may last months to years

A

Delirium

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2
Q

What are some symptoms of mild alcohol withdrawl?

(seen 5-10 hours after cessation, peaking 2-3 days after cessation)

A

Tremor
Agitation
Anxiety

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3
Q

Acute alcohol withdrawal syndrome..can be life threatening!!

Sx: agitation, tremor, hallucinations
seizures, ANS instability (increased BP, pulse, respirations)

A

Delirium tremens (DT)

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4
Q

How do you tx Delirium Tremens (DT)

A

Benzos
Phenobarbital
Haldol

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5
Q

Is dementia a normal part of aging?

A

NO

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6
Q

Continuum of diseases
Memory loss
other problems:
speech/language difficulties
problem solving difficulties
impaired judgement
mood issues

*often progressive

A

Dementia

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7
Q

Changes in cerebral circuits

Nerve loss

Changes in neurotransmitters:
Ach, Serotonin, Glutamine, etc.

A

Neurological features of dementia

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8
Q

Biggest risk factor for dementia?

A

AGE!

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9
Q

Creutzfeld-Jakob viral infection can cause…

A

Dementia (fast progressing!)

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10
Q
  1. Alzheimer’s
  2. Vascular
  3. Multi infarct
  4. Frontotemporal (Huntington’s)
  5. Parkinson’s
  6. ETOH/Drugs
  7. Viral/priod disease (Creutzfeld-Jakob)
A

Types of dementia

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11
Q

What makes up more 50% of dementias?

(Green PANCE book says up tp 60-80%)

A

Alzheimer’s disease

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12
Q

Pathology:

Neuritic plaques
Amyloid deposition in arterial walls of neurons
Neurofibrillary tangles in cytoplasm of neurons

More common in women.
Higher incidence in down syndrome

A

Alzheimer’s disease

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13
Q

Genetic predisposition

*linked to chromosomes 1, 14, 19 and 21

A

Alzheimer’s disease

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14
Q

Steadily progressive memory loss and other cognitive deficits, which typically begin during sixth or seventh decade of life

intracellular neurofibrillary tangles and extracellular neuritic plaques

A

Alzheimer’s disease

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15
Q

An otherwise alert patient exhibits:

Progressive memory loss and other cognitive deficits, such as:
Disorientation
Language difficulties
Inability to perform complex motor activities
Inattention
Visual misperception
Poor problem solving abilities
Inappropriate social behavior
Hallucinations

A

Alzheimer’s disease

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16
Q

What is death usually due to in Alzheimer’s?

A

Infection, malnutrition, or heart disease

*usually within 8-10 years (can be up to 25 years)

17
Q

Autosomal dominant
Chromosome 4
50% chance of getting if 1 parent has

motor and cognitive problems
onset ~35-45 yo
fatal in 20-25 years

A

Huntington’s

18
Q

AKA multi infarct dementia
classically hypertensive patients
+/- history of TIA, stroke

Usually manifests as forgetfulness in absence of depression or inattentiveness
*typically occurs in stepwise fashion, related to area of CNS affected

A

Vascular dementia

19
Q

Type of dementia seen in:
Huntington’s, Pick’s disease, Progressive supranuclear palsy

*memory loss typically later in disease
early features:
attention issues
judgment impairment
awareness
behavior problems

*aphasia seen

A

Frontotemporal dementias

20
Q

What type of dementia is associated with:

behavioral symptoms (euphoria, apathy, disinhibition) and compulsive disorders

*several primative reflexes:
palmomental
palmar grasp
rooting

A

Frontotemporal dementia

21
Q

Do all patient’s with Parkinson’s get dementia?

A

NO

22
Q

Visual hallucinations
Parkinson’s like features
Decreases alertness
Episodic confusion that waxes and wanes
May have cholinergic defect

tx= Anti-cholinergics

A

Lewey Body Dementia

23
Q

Tremor
Rigidity
Makes facies
Bradykinesia
Cogwheeling

+dementia

..what type?

A

Parkinson’s dementia

24
Q

Intraneuronal cytoplasmic inclusions that stain with PAS staining

A

Lewey bodies

25
Q

Gate ataxia
Dementia
Urinary incontinence

CT scan will show large ventricles

Tx= shunting

A

Normal pressure hydrocephalus (NPH)

26
Q

What type of encephalopathy can be caused by Thiamin deficiency?

(seen in alcoholics)

A

Wernicke’s

27
Q

Imaging reveals: diffuse atrophy of the cerebral cortex with enlargement of ventricles

Microscopic features: neuritic (senile) plaques, patches or flat areas composed of clusters of degenerative nerve terminals arranged around a central amyloid core

cytoplasm has neurofibrillary tangles

A

Alzheimer’s disease

Clin Med- Neuro (10 decks)

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