Dementia/NTBI Review

Question 1

Etiologies of NTBI

Answer 1

• brain tumors
• asphyxiation/suffocation
• anoxic/hypoxic injury
• seizures
• encephalitis
• virus
• meningitis
• stroke
• drug abuse

Question 2

T/F Dementia: Impairments of cognitive function are commonly accompanied, and occasionally preceded, by deterioration in emotional control, social behavior, or motivation

Answer 2

True

Question 3

Early signs of dementia

Answer 3

• memory failure
• disorientation
• lapses in judgment
• difficulty performing activities of daily life
• difficulty performing mentally challenging tasks
• misplacing things
• apathy and loss of initiative
• change in mood

Question 4

Dementia syndromes is divided into 3 major categories, what are they?

Answer 4

1. Cortical dementia- changes in cerebral cortex (Alzheimer’s)
2. Subcortical dementia- changes in basal ganglia, thalamus, and brain stem (Parkinson’s, Huntington’s)
3. Mixed dementia- caused by changes in cortical and subcortical structures

Question 5

Cortical dementia examples

Answer 5

Alzheimer’s

Question 6

Subcortical dementia examples

Answer 6

• Parkinson’s
• Huntington’s
• Progressive supranuclear palsy
• AIDS

Question 7

Mixed dementia examples

Answer 7

• vascular dementia
• Lewy body dementia
• frontotemporal dementia (Pick’s disease)

Question 8

Subcortical dementia: Cortical function impairments occur in the _____ stages;
Motor impairments are evident in the ______ stages

Answer 8

later; early

Question 9

Subcortical dementia:

First signs of dementia appear ___ to ____ after the appearance of motor impairments (as the disease progresses)

Answer 9

months to years

Question 10

T/F Most SDs are delayed consequences of extrapyramidal system disease and reveal volitional movement impairment

Answer 10

true

Question 11

Parkinson’s: disturbances of movement including….

Answer 11

muscle rigidity, tremor, slowness, or abolition of movement, and loss of balance

Question 12

T/F Women are affected by Parkinson’s more than men

Answer 12

false; men>women

Question 13

Parkinson’s is caused by deterioration of dopaminergic neurons in ____ and ____

Answer 13

basal ganglia and brainstem

Question 14

What is the primary tx for Parkinson’s?

Answer 14

Levodopa (body converts to dopamine)

Question 15

T/F Micrographia is common in Parkinson’s

Answer 15

true

Question 16

T/F Vocabulary, syntax, and grammar are preserved in Parkinson’s

Answer 16

false; preserved until the later stages

Question 17

Huntington’s is an inherited….

Answer 17

degenerative neurologic disease

Question 18

T/F There is no cure for Huntington’s

Answer 18

true

Question 19

What are the first symptoms of Huntington’s?

Answer 19

• involuntary movements

- irritability, emotional outbursts, mental deterioration, memory, progressive motor impairments

Question 20

Stages of Huntington’s

Answer 20

• cognition and communication
• dysarthria
• dysphagia
• final stages: mute, incontinent and profoundly demented

Question 21

Progressive Supranuclear Palsy: what disease does it resemble?

Answer 21

Parkinson’s

Question 22

Early symptoms of PSP

Answer 22

paralysis of muslces responsible for downward gaze, rigidity of neck muscles, facial muscle weakness

Question 23

Symptoms of progression in PSP

Answer 23

pt loses vertical and lateral eye movements, limbs become stiff and rigid, dysarthria, and dysphagia

Question 24

T/F there is no known tx for PSP

Answer 24

true

Question 25

PSP speech characteristics

Answer 25

- dysarthria - speech is slow - repetition - reduced vocal loudness

Question 26

T/F Language is not affected in PSP

Answer 26

true; language remains intact

Question 27

T/F mutism is common in early stages for PSP

Answer 27

false; common in very late stages

Question 28

What percent of persons with AIDS develop AIDS dementia complex?

Answer 28

70%

Question 29

Early symptoms of AIDS dementia

Answer 29

extrapyramidal pathology (weakness, slowness, rigidity, dyskinesia)

Question 30

Later symptoms of AIDS dementia

Answer 30

cortical involvement (declined perception, memory, intellect, language)

Question 31

T/F Alzheimer's: Men>women

Answer 31

false; women are affected more than men

Question 32

Alzheimer's: 3 microscopic changes in brain neurons, what are they?

Answer 32

1. neurofibrillary tangles 2. neuritic plaques 3. dranulovacular degenearation

Question 33

Alzheimer's: 1st symptoms

Answer 33

memory lapses, faulty reasoning, poor judgment, disorientation, mood changes

Question 34

T/F Vascular dementia is the leading cause of dementia in adults

Answer 34

false; AD is first, VD is second

Question 35

T/F Pure vascular dementia is relatively uncommon

Answer 35

true; majority have AD and VD

Question 36

Frontotemporal dementia (FTD) leads to tissue ____ and reduced ____ in the brain's frontal and temporal lobes

Answer 36

shrinkage; function

Question 37

T/F FTD is rare

Answer 37

false; it was once considered to be rare, but it's now thought to account for up to 10-15% of all dementia cases

Question 38

3 broad categories of FTD are...

Answer 38

1. behavioral-variant FTD 2. Semantic dementia 3. Progressive non-fluent aphasia

Question 39

Semantic dementia: people speak easily, but their words convey less and less ____

Answer 39

meaning

Question 40

Semantic dementia: T/F tend to use broad general terms such as "animal" when they mean "cat"

Answer 40

true

Question 41

Progressive non-fluent aphasia: people loose their ability to generate ____ easily, and their ____ becomes halting, "tongue-tied" and ungrammatical

Answer 41

words; speech

Question 42

Other causes of dementia

Answer 42

- normal pressure hydrocephalus - mad cow disease - late stages of ALS, MS - brain tumors and chronic SDH - bacterial or viral infections of the brain (meningitis, encephalitis) - hemodialysis

Question 43

Pseudodementia: symptoms of _____ may mimic symptoms of dementia

Answer 43

depression

Question 44

Individual experiences confusion, disordered thinking, disorientation, agitation, hyperactivity, distractibility, and sometimes delusions and hallucinations, and may be caused by:

Answer 44

- medicataion - infections (e.g. UTI) - metabolic disorders - surgery, anesthesia - substance withdrawl - toxins (carbon monoxide poisoning) - ICU delirium