Disorders of Thinking and Memory Flashcards

1
Q

List some causes of dementia

A

Alzheimer’s disease (major cause of dementia)

Acquired

Primary neurodegenerative disease

Stroke

Family history

Diabetes mellitus

Vascular disease

History of head injury

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2
Q

What is the major cause of dementia?

A

Alzheimer’s disease

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3
Q

“Chronic brain syndrome” is also known as what?

A

dementia

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4
Q

Mild cognitive impairment; change in the level of function
The diagnosis involves functional impairment

A

dementia

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5
Q

What are the signs and symptoms of dementia?

A

Short-term memory loss
Word finding difficulty (progressive non-fluent aphasia)
Visuospatial dysfunction
Poor facial recognition
Apathy
Apraxia
Executive dysfunction
Behavioral

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6
Q

What are two tests that can be used to test for dementia?

A

MMSE- Mini Mental Status Exam (The Folstein)

Montreal Cognitive Assessment

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7
Q

What is the most common related neurodegenerative dementia after age 60?

A

Alzheimer’s Disease

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8
Q

What is the gold standard of diagnosis for Alzheimer’s disease?

A

post mortum brain biopsy

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9
Q

B-amyloid-laden senile plaques and neurofibrillary tangles makes you think of what diagnosis?

A

Alzheimer’s Disease

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10
Q

The second most common cause of dementia is what type?

A

Vascular Dementia

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11
Q

What is the pathophysiology of vascular dementia?

A

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

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12
Q

What is the test of choice for vascular dementia?

A

MRI test of choice

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13
Q

What is the treatment for vascular dementia?

A

There are no treatments specifically for vascular dementia. Treatment aimed at controlling HTN, hyperlipidemia, DM, etc

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14
Q

What is the pathophysiology for Lewy Bodies dementia?

A

Accumulation of alpha synuclein-containing neuronal inclusions

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15
Q

What is a classic finding in Lewy Bodies dementia?

A

Visual hallucinations

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16
Q

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

A

Lewy Bodies dementia

17
Q

Cortical ribboning and “prion” disease is diagnostic of what type of dementia?

A

Creutzfeldt-Jakob Disease

18
Q

What is the cause of Creutzfeldt-Jakob Disease?

A

Results from ingestion of beefsteak contaminated with neural tissue
(brain, spinal cord) from livestock infected with bovine spongiform
encephalopathy

19
Q

What type of dementia would you see gait apraxia and “magnetic gait” – feet are stuck to the floor, as well as Urinary incontinence

A

Normal Pressure Hydrocephalus

20
Q

What is the treatment for Normal Pressure Hydrocephalus?

A

Lumbar puncture to drainage excess fluids

If gait improves, lumboperitoneal shunt can be done (long term
management)

21
Q

What are the CT/MRI findings in norma pressure hydrocephalus?

A

ventricles are enlarged, disproportionate to sulcus widening and
overall brain atrophy

22
Q

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

23
Q

What are some associated features of Delirium?

A

disruption of the sleep-wake cycle
drowsiness
restlessness
incoherence irritability
emotional liability
perceptual
misinterpretations (illusions)
hallucinations

24
Q

What is the most common cause of delirium?

A

UTI or other infectious source

25
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
26
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
27
What are the risk factors for delirium?
Underlying dementia Stroke Other neurological abnormality Advanced age Sensory impairment
28
What is the workup for delirium?
extensive lab workup Brain imaging EEG
29
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