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exam#2 485 > Dementia (part 1 & 2) > Flashcards

Dementia (part 1 & 2) Flashcards

1
Q

> 85 YOA is fastest growing demographic group. t/f

A

t

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2
Q

What are the “cluster” of symptoms that make up Dementia? (5)

A
  1. forgetfulness (progressive)
  2. difficulty doing familiar tasks
  3. confusion
  4. poor judgment
  5. decline in intellectual functioning
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3
Q

Is dementia a part of “normal” aging?

A

no

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4
Q

Dementia is not just ____ disease. It is used to describe a _______ of diseases/symptoms.

A

one

group

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5
Q

Dementia has ________ syndromes.

A

acquired

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6
Q

Dementia involves short term memory, social and/or occupational impairments, and at least one of the following: (4)

A
  1. aphasia
  2. apraxia
  3. agnosia
  4. abstract thinking/executive function impairments
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7
Q

What is apraxia?

A

motor memory impairment (loss of ability to coordinate learned body movements)

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8
Q

What is aphasia?

A

language impairments (inability to speak or understand)

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9
Q

what is agnosia?

A

sensory memory impairments (inability to recognize what is seen) NOT just a memory problem.

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10
Q

most people with dementia will visit a doctor when what type of problems occur with dementia?

A

social issues, problems on the job, multitasking, spousal complaints

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11
Q

dementia or normal aging?

only mentions memory loss when asked, can’t give examples

A

dementia

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12
Q

dementia or normal aging?

close family members are much more concerned about memory problems than the patient is.

A

dementia

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13
Q

How many levels of dementia are there?

A 
6
questionable
mild
moderate
severe
profound
terminal
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14
Q

how long does the early stage of dementia last?

A

virtually no time to about 5 years

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15
Q

what are common characteristics (minor changes) of the early stage of dementia?

A

Difficulty remembering most recent information
Difficulty performing familiar tasks
Decreased or altered judgment
Language Changes (speech, word-finding, etc.)
Changes in personality, behavior, & mood (worsening)
Disoriented with time and place
Problems with abstract thinking

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16
Q

what is the time frame of the middle stage of dementia?

A

2-12 years

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17
Q

symptoms are usually more obvious for dementia during what stage?

A

middle

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18
Q

what are characteristics of the middle stage of dementia?

A

Remembers less and less (Forgets quicker than in Early Stage)
Increased difficulty or inability to perform familiar tasks
Lack of judgment
Increased changes in behavior, mood, and personality (suspiciousness)
More confused about time and place
Loss of ability to think abstractly
Changes in the five senses
Physical changes (loss of bladder control, less steady while walking, etc.)

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19
Q

what stage of dementia do people usually go for help?

A

middle

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20
Q

what stage of dementia will physical changes happen?

A

middle (loss of bladder control, unsteady walking)

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21
Q

what is the time frame for the late stage of dementia?

A

1-3 years

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22
Q

what are characteristics of late stage dementia?

A 
Little or no short term memory remains
Unable to perform tasks
Lack of judgment
Unable to communicate effectively 
Doesn’t recognize self or family
Puts things in their mouth or touches & grabs things
Five senses have little or no function
Physical activity declines (loss of ability to walk and/or trouble swallowing)
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23
Q

what is when therapy is given to help prolong abilities they do have

A

mild-moderate

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24
Q

what is the Etiology of Dementia�

A

impaired functioning of MULTIPLE brain systems in both cortical and sub-cortical areas
�

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25
Q

what happens to the brain with dementia?

A

structural brain damage (neurons are breaking down) that is often progressive and relatively irreversible

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26
Q

Coritcially and subcortical structures are involved with the impairment; making this a _______ issue

A

global

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27
Q

dementia is a diffuse, progressive damage. t/f

A

true

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28
Q

what are the 2 most common dementia’s?

A

alzheimers

vascular

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29
Q

What are some of the “other” categories for dementia?

A

alcohol related, Pick’s disease, HSE (herpes virus gets into spinal fluid)

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30
Q

Under the age of 65, _______ dementia is the most common dementia.

A

frontotemporal

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31
Q

under the age of 55, _____ dementia is the most common dementia.

A

HIV

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32
Q

What type of dementia is language specific and may be helped through therapy

A

frontotemporal

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33
Q

What type of dementia reacts to the autoimmune system and deteriorates the brain?

A

HIV

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34
Q

what is the first prominent symptom of Alzheimer’s disease?

A

short term memory loss

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35
Q

What are the 3 consistent changes seen in the structure of the brain in Alzheimer’s?

A
  1. Amyloid plaques
  2. neurofibrillary tangles
  3. neuronal degeneration
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36
Q

In AD structural changes in the brain happen YEARS before behavioral symptoms. T/F

A

true

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37
Q

tangles affect the ____

A

nureons

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38
Q

What type of scans will show a activity of the brain and help to show if the brain is being affected by tangles and plaques?

A

PET scans

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39
Q

what symptoms are apparent in the mild stage of AD?

A 
Cognitive symptoms
require assistance with ADL
memory loss
language problems
mood swings
personality changes
diminished judgment
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40
Q

what symptoms are apparent in the moderate stage of AD?

A

behavioral, personality changes
unable to learn/recall new info
long-term memory affected
wandering, agitation, aggression, confusion

41
Q

what symptoms are apparent in the severe stage of AD?

A

gait
incontinence
bedridden
placement in long-term care

42
Q

Is down syndrome a risk factor for AD?

A

yes

43
Q

are females more at risk for AD?

A

yes

44
Q

is ethnicity a risk factor for AD?

A

yes. Caucasians have the lowest risk due to general health

45
Q

what is APOE?

A

the gene linked with AD

46
Q

is head trauma a risk factor for AD?

A

yes

47
Q

what type of dementia has an abrupt onset of symptoms followed by stepwise deterioration?

A

vascular

48
Q

what age group is vascular dementia more prevalent?

A

before 75 YOA

49
Q

what age group is AD more prevalent?

A

75+

50
Q

what are 3 risk factors for vascular dementia?

A

older age
hypertension
diabetes

51
Q

what is classified as “other” dementia?

A

frontotemporal (including progressive aphasia)

52
Q

what are some infectious causes of the “other” dementia’s?

A

neurosyphilis (30% of untreated syphilis pts)
Lyme disease
Herpes encephalitis dementia
viral, parasitic, bacterial
infections or brain abscess
Human prion (proteins) disease: ‘Mad-cow disease’, Kuru, fatal familial insomnia

53
Q

what is ALWAYS present during Clinical Presentation of Dementia

A

cognitive disturbances

functional impairment

54
Q

what is often time present during clinical presentations of dementia?

A 
visuospatial impairments (reading/conversations)
behavioral distrubances
55
Q

what are Visuospatial impairments

A

visual recognition

spatial deficits

56
Q

what is capgras syndrome?

A

trouble recognizing familiar faces.

57
Q

getting lost in familiar surroundings, 3-D drawing deficits, trouble replicating a drawing, would be what type of deficit?

A

spatial deficits

58
Q

personality change will happen ______ in dementia

A

early

59
Q

personality change can be affected in 3 different ways

A

passivity (apathy, withdrawal)
disinhibition (inappropriate sexual behavior/language)
self-centered behaviors

60
Q

______ is very common and frequently worsens as the illness progresses.

A

agitation

61
Q

what are some common behavioral disturbances with dementia?

A

agitation
depression
psychosis (delusions, perceptual disturbances)
sleep disturbances

62
Q

what are some memory impairments associated with dementia?

A

forming new memories
retrieval deficits
episodic (misplacing items)

63
Q

language deficits of dementia include:

A

anomia
fluency
less complex sentences
semantic paraphasias

64
Q

what stage is this:
Uses frequent stereotypical utterances
unable to generate a sequence of related ideas.
Patient begins to exhibit semantic impairment
slightly reduced vocabulary
word finding difficulties
increased use of automatisms and clichés.
Errors are often self-corrected

A

early

65
Q

during the early stage of dementia what 2 aspects of language are still intact?

A

syntax

phonology

66
Q

surface dyslexia

A

errors with irregular words (yacht)

67
Q

during the early stage of dementia reading ____ words and _____ is spared although there are errors with ______ words

A

regular
nonwords
irregular

68
Q

during the early stage of dementia many lose the desire to communicate. t/f

A

t

69
Q

during the early stage of dementia there is speech inhibitions. t/f

A

t

70
Q

during what stage of dementia is Speech perseverative, non-meaningful

A

middle

71
Q

during what stage of dementia are language error not self corrected?

A

middle

72
Q

during what stage of dementia does the patient show further semantic impairments such as: significantly reduced vocabulary
errors semantically and visually related.
More semantic
utterances are usually very concrete
�

A

middle

73
Q

during the middle stage of dementia speech production is _______ in syntactic complexity and ________ skills deteriorate

A

reduced

repetition

74
Q

reading and writing skills during the middle stage of dementia includes:
____ and ______ impaired.
______ dysgraphia emerges.

A

nonword
irregular
surface (yacht–>yot)

75
Q

diminished eye contact begins during what stage of dementia?

A

middle

76
Q

declining sensitivity to context begins during what stage of dementia?

A

middle

77
Q

what stage does patient require extensive personal care?

A

late

78
Q

what stage does this happen?
very reduced vocabulary.
frequent use of unrelated meanings.
Frequent paraphasias / neologistic speech

A

late

79
Q

At what stage is further syntactic and phonological impairments in speech production noticeable?

A

late

80
Q

What stage is all reading and writing impaired?

A

late

81
Q

What stage is there no adherence to conversational rules, poor eye contact, and lack of social awareness?

A

late

82
Q

Executive function impairments are due to _____ ____ dysfunction.

A

frontal lobe

83
Q

_________ ________ impairments may include: planning, predicting, correlating, abstract ideas.

A

executive function

84
Q

Pronounced deficits often seen in FTD’s before overt ______ impairment.

A

memory

85
Q

The lack of taking multiple threads of information and processing it to make a decision is an example of

A

executive function impairments

86
Q

Functional impairment and performance on cognitive testing may not correlate strongly early in the course of dementia

A

true

87
Q

Rate and specific pattern of loss will vary by individual and somewhat by diagnosis

A

t

88
Q

functional impairments will show deficits first in ???

A

IADL activities of daily living

managing finances, driving, keeping appointments

89
Q

how is dementia different than normal aging?

A

not aware of their deficits

90
Q

normal aging or dementia:

Frequent word finding difficulties

A

dementia

91
Q

normal aging or dementia?

Only mentions memory loss when asked, can’t give examples

A

dementia

92
Q

normal aging or dementia?

Patient is more concerned about forgetfulness than close family are

A

normal aging

93
Q

what are some causes/predictors of dementia?

A 
Age
Family history / genetics
Down’s syndrome 
Head Trauma (esp. late in life)
Female gender 
Ethnicity (Caucasians have the lowest risk; general health)
Late-onset depression (after age 65)
Mild Cognitive Impairment (MCI)
94
Q

what are some characteristics of the brains of individuals with dementia, and particularly Alzheimer’s?

A

plaques, tangles, decay

95
Q

how is memory affected by dementia?

A
  1. difficulty forming new memories
  2. information retrieval
  3. misplacing items
  4. implicit memory better than declarative (knowing “what” is more important than knowing “how”)
96
Q

how is vascular dementia different than aphasia?

A

?/

97
Q

what are the language deficits affected by dementia?

A

anomia
fluency
less complex sentences
semantic paraphasias

98
Q

what language aspect is generally preserved in people with dementia?

A

auditory comprehension

exam#2 485 (7 decks)

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