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Neuro II Exam 2 > Dementias - Cohen > Flashcards

Dementias - Cohen Flashcards

1
Q

risk fx dementia

A

aging

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2
Q

dementia

A

develop multi cognitive defects sufficient to cause impairment in occupational and social fxn

progressive and likely irreversible decline

not temporary (like delirirum)

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3
Q

MC cause of dementia

A

alhzeimers

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4
Q

beta-amyloid plaques

A

alzheimers

AB42

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5
Q

tau tangles

A

alzheimers - microtubules inside neurons

phosphorylated tau

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6
Q

down syndrome

A

almost all get alzheimers - so chromosome 21 may play a role

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7
Q

alzheimers

A

see loss of ACh

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8
Q

beta-amyloid

A

AB42

produced from APP by secretases

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9
Q

alzheimers epidemiology

A

older - >80yo in 10-25%

more common in women

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10
Q

homozygous at E4 allele of apoE

A

more prone to alzheimers

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11
Q

alzheimers clinical course

A 
begins - loss of memory
speech restricted to simple phrases
trouble day to day affairs
visuospatial decline - get lost
gait disorder
depression, bored, lack social inhibition
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12
Q

apraxia

A

loss of simple actions/certain tasks
-loss of connections between cortical sites

in alzheimers

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13
Q

mild alzheimers

A

safe at home, some help with activities, not a threat

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14
Q

moderate alzheimers

A

kept at home with great effort

-full or nearly full time caregiver

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15
Q

severe alzheimers

A

must go to nursing home - round clock supervision

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16
Q

diagnosis of alzheimers

A

clinical diagnosis

possible diagnostic test - inject PiB (pitt compound) and use PET scan to see amyloid deposition in brain

CSF levels of beta-amyloid decrease and tau increase

MRI - atrophy medial temporal lobe

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17
Q

tx of AD

A

cholinesterase inhibitor

  • raise ACh levels
  • may help symptoms

donepezil**
rivastigmine
galantamine
memantine $$$

18
Q

donepezil

A

most widely used tx for AD - fewest adverse effects

-taken once daily

19
Q

memantine

A

antagonist of glutamate

prevent cell death from glutamate activity

tx of AD - but $$$

20
Q

mild cognitive impairment

A

mild AD
-still fxn in social and job roles

lots progress to AD

21
Q

lewy body disease

A

fluctuating dementia

wild and crazy

decreased facial animation, slow, imbalance, tremor
-mild/moderate parkinsonian sx

EARLY dementia and agitation

more common in men

22
Q

dementia fluctuating, visual hallucinations, parkinsonism

A

lewy body dementia

23
Q

bad response to antipsychotic

A

lewy body dementia

24
Q

tx of lewy body dementia

A

may improve with AChE drugs

25
Q

lewy bodies

A

contain protein alpha-synuclein

26
Q

clinical course of lewy body disorder

A

rapid decline
-death 5-7 years

psychotic behavior that fluctuates
-with visual hallucinations

27
Q

diagnosis of lewy body disorder

A

clinical diagnosis

AChE tx somewhat effective

28
Q

prior strokes with step like downhill course

A

multi-infarct dementia

seizures common

likely CAD, PVD, or carotid stenosis - seen on U/S

29
Q

risk fx for multi-infarct dementia

A

HTN, diabetes, hyperlipidemia

30
Q

tx of multi-infarct dementia

A

control risk fx - aspirin and anti-coags

31
Q

fronto-temporal dementia

A

family of multi disorders
-early age of onset 50-60yo

decline in behavior and speech

incrased tau protein, TDP43, and ubiquitin

32
Q

increased tau, TDP43, and ubiquitin

A

seen in fronto-temporal dementia

33
Q

behavior dominant FTD

A

most patients

personality change

  • obsessed with certain subject - sing song over and over
  • over eat, over drink
  • occasional become weak

no hallucinations

34
Q

language predominant form of FTD

A

progressive aphasia

left frontal and temporal lobe - more atrophy

mute in few years

35
Q

tx of FTD

A

antidepressant somewhat help

36
Q

creutzfeldt jakob disease

A

prions

-proteins

37
Q

rapid dementia over 1 year with myoclonic jerks

A

CJD

spongiform brain

EEG - triphasic waves - diffuse periodic wave pattern

38
Q

14-3-3 in CSF

A

CJD

39
Q

prion path

A

change in shape of proteins

40
Q

normal pressure hydrocephalus

A

gait disturbance
incontinence
dementia

have large lateral ventricles

see normal P on spinal tap

41
Q

tx of NPH

A

shunting

42
Q

diagnosis of NPH

A

remove 30cc from CSF with lumbar pucture - symptoms better

Neuro II Exam 2 (20 decks)

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