Dementia (Hon)

Question 1

Dementia

Answer 1

decline in memory and at least one other cognitive function (aphasia, executive functions -planning, organizing, etc)

Question 2

How are all degenerative disorders definitively confirmed?

Answer 2

at autopsy

Question 3

What is the most common cause of dementia?

Answer 3

Alzheimer’s disease (80%)

Question 4

What part of the evaluation is crucial in a patient you suspect with dementia?

Answer 4

history, history, history - often needed from others close to the patient (caregivers/family members)

Question 5

Criteria for clinical diagnosis of Alzheimer’s disease?

Answer 5

deficits in 2 or more areas of cognition with progressive worsening of memory and another cognitive function with absence of systemic disorders or other brain disease

Question 6

Labs of a patient with Alzheimer’s disease?

Answer 6

normal lumbar puncture
EEG normal or mild generalized slowing
Brain MRI or CT will show progressive atrophy

Question 7

What is the main goal of Alzheimer’s disease?

Answer 7

slow the progression of the disease

Question 8

What agents are used in Alzheimer’s disease to slow the progression?

Answer 8

Acetylcholinesterase inhibitors: Donepizil, Rivastigmine and Galantamine
NMDA receptor antagonist: Memantine

Question 9

Mild Cognitive Impairment (MCI)

Answer 9

memory complaint that is abnormal for age; often noted by patient but there is normal general cognitive function and normal activities of daily living; 5X more likely to develop Alzheimer’s disease

Question 10

Vascular dementia

Answer 10

cerebrovascular disease defined by relation between cognitive problems and vascular events; onset of dementia within 3 months after a recognized stroke

Question 11

Tetrad of symptoms with diffuse Lewy body disease?

Answer 11

dementia
Bradykinesia
Rigidity w/o tremor
psychotic symptoms (visual illusions/hallucinations)

Question 12

What is the most common psychotic symptom in a patient with diffuse Lewy body disease?

Answer 12

visual hallucinations (generally animals or people; often children)

Question 13

Why are antipsychotic medications not recommended for patients with diffuse Lewy body disease?

Answer 13

these patients can experience severe potentially life-threatening adverse reactions

Question 14

Frontotemporal degeneration

Answer 14

slowly progressive deterioration of social skills and changes in personality along with intellect, memory and language (shorter duration of progression and very poor prognosis); age 40 yrs; atrophy of frontal and temporal lobes of the brain; no cure

Question 15

Normal Pressure Hydrocephalus (NPH) triad of symptoms?

Answer 15

Dementia
Gait disturbance
Urinary incontinence

Question 16

What is most likely to be reversed in a patient with corrected normal pressure hydrocephalus?

Answer 16

gait disturbance

Question 17

What is the treatment for NPH that is potentially reversible if caught early?

Answer 17

ventriculoperitoneal shunt (VP shunt)