Dementia Quiz Flashcards
All of the following are cholinesterase inhibitors except:
A) Donepezil
B) Rivastigmine
C) Memantine
D) Galantamine
C – memantine is an NMDA antagonist
A cholinesterase inhibitor can be thought of as:
A) Anticholinergic
B) Procholinergic
C) Glutamate agonists
D) Dopamine agonists
B – inhibition of cholinesterase increases the concentration of acetylcholine within the synapse
T or F: treatment of dementia with cholinesterase inhibitors and memantine can result in statistically significant but clinically marginal improvement in measures of cognition and global assessment of dementia.
True
T or F: Anticholinergic adverse effects of cholinesterase inhibitors are best managed with a scopolamine patch.
False – scopolamine is an anticholinergic itself so it would WORSEN the effects of cholinesterase inhibitors, and its indication is for post op N/V
T or F: Anticholinergic adverse effects of cholinesterase inhibitors can be managed by changing from oral therapy to topical therapy.
True
T or F: Symptomatic bradycardia and syncope caused by cholinesterase inhibitors can precipitate fall-related injuries.
True
T or F: Agitation when seen in conjunction with AD should be conservatively managed using neuroleptics only when other measures fail and using low dose neuroleptics for short periods of time.
True
In class we discussed the case of a 74 y/o F patient with AD successfully managed with donepezil and multiple non-pharmacologic methods. For the past two months she reports urinary frequency, and burning on urination. She has had episodes of urinary incontinence managed with daily oxybutynin since this December.
In the past month (February) her personality has changed from cooperative to non-cooperative, she displays lack of interest, apathy, and tearfulness. Her MMSE assessment has significantly deteriorated since her last visit 2 months ago. This patient would significantly improve after:
A) Increasing the dose of donepezil, and adding memantine
B) Adjusting her dose of thyroid replacement
C) Discontinuing oxybutynin and working up and then treating a lower UTI
D) Switching from donepezil to topical Rivastigmine
C
Lecanemeb, the newly approved anti-myeloid antibody:
A) Arrests cognitive decline after 18 months
B) Modestly slowed cognitive decline after 18 months but not after 12 months
C) <1% of patients taking Lecanemeb have imaging evidence of cerebral bleeding
D) Is effective for patients with moderate to severe cognitive impairment
E) Patients should be started on daily aspirin one month prior to lecanemeb treatment
B
