Disorders of Thinking and Memory Flashcards
List some causes of dementia
Alzheimer’s disease (major cause of dementia)
Acquired
Primary neurodegenerative disease
Stroke
Family history
Diabetes mellitus
Vascular disease
History of head injury
What is the major cause of dementia?
Alzheimer’s disease
“Chronic brain syndrome” is also known as what?
dementia
Mild cognitive impairment; change in the level of function
The diagnosis involves functional impairment
dementia
What are the signs and symptoms of dementia?
Short-term memory loss
Word finding difficulty (progressive non-fluent aphasia)
Visuospatial dysfunction
Poor facial recognition
Apathy
Apraxia
Executive dysfunction
Behavioral
What are two tests that can be used to test for dementia?
MMSE- Mini Mental Status Exam (The Folstein)
Montreal Cognitive Assessment
What is the most common related neurodegenerative dementia after age 60?
Alzheimer’s Disease
What is the gold standard of diagnosis for Alzheimer’s disease?
post mortum brain biopsy
B-amyloid-laden senile plaques and neurofibrillary tangles makes you think of what diagnosis?
Alzheimer’s Disease
The second most common cause of dementia is what type?
Vascular Dementia
What is the pathophysiology of vascular dementia?
Stepwise accumulation of cognitive symptoms associated with multiple
stroke
Little small strokes over a period of time 🡪 eventually the cumulative effects of the infarcts begins to show up
What is the test of choice for vascular dementia?
MRI test of choice
What is the treatment for vascular dementia?
There are no treatments specifically for vascular dementia. Treatment aimed at controlling HTN, hyperlipidemia, DM, etc
What is the pathophysiology for Lewy Bodies dementia?
Accumulation of alpha synuclein-containing neuronal inclusions
What is a classic finding in Lewy Bodies dementia?
Visual hallucinations
Which of the types of dementia is described below?
Shows a more rapid decline than Alzheimer’s
Parkinson’s disease may occur along or after cognitive symptoms start
Patients have difficulty with executive and visuospatial function
Visual hallucinations are classic
Lewy Bodies dementia
Cortical ribboning and “prion” disease is diagnostic of what type of dementia?
Creutzfeldt-Jakob Disease
What is the cause of Creutzfeldt-Jakob Disease?
Results from ingestion of beefsteak contaminated with neural tissue
(brain, spinal cord) from livestock infected with bovine spongiform
encephalopathy
What type of dementia would you see gait apraxia and “magnetic gait” – feet are stuck to the floor, as well as Urinary incontinence
Normal Pressure Hydrocephalus
What is the treatment for Normal Pressure Hydrocephalus?
Lumbar puncture to drainage excess fluids
If gait improves, lumboperitoneal shunt can be done (long term
management)
What are the CT/MRI findings in norma pressure hydrocephalus?
ventricles are enlarged, disproportionate to sulcus widening and
overall brain atrophy
State of confusion that is acute, abrupt onset with fluctuating course
REVERSIBLE
Refers to a global mental dysfunction marked by a disturbance of consciousness,
especially reduced awareness of the environment and inability to maintain
attention
Delirium
What are some associated features of Delirium?
disruption of the sleep-wake cycle
drowsiness
restlessness
incoherence irritability
emotional liability
perceptual
misinterpretations (illusions)
hallucinations
What is the most common cause of delirium?
UTI or other infectious source
What are some causes of delirium?
Infectious
Medication
EtOH intoxication or withdrawal
Seizure
Stroke
Metabolic disorders
Endocrine disorder
Renal disorder
Liver disorder
Nutritional
Sleep deprivation
What are some features that someone with delirium would present with?
Impaired attention rather than impaired memory (Although delirium can coexist with dementia)
Disorientation
Wandering
Day/night confusion
Exam is often non-focal
What are the risk factors for delirium?
Underlying dementia
Stroke
Other neurological abnormality
Advanced age
Sensory impairment
What is the workup for delirium?
extensive lab workup
Brain imaging
EEG
What is the treatment/management of delirium?
The best treatment is prevention
Management/treatment consists of correcting the underlying cause
Supportive care, reassurance, re-orientation
