DSA 33 Dementia Flashcards
what is the difference between dementia and delirium?
delirium is an acute decline in cognition that fluctuates over hours/days
potentially reversible dementia if discovered early
normal pressure hydrocephalus
What are conditions that cause dementia?
NPH, Alzehimers, Parkinson’s dementia, and vascular dementia Frontotemporal Lobar Degeneration
What does a patient with NPH have a history of?
head injury, meningitis, or subarachnoid hemorrhage
pharmacology for AD?
donepezil, rivastigmine, galantamine, memantine which is not really good treatment
What are the two types of vascular dementia?
multi-infarct dementia and diffuse white matter disease (Binswanger’s disease)
What distinguishes the two types of vascular dementia?
MRI
What are the three types of FTD?
behavioral variant and two forms of primary progressive aphasia (semantic and nonfluent/agrammatic variant)
What major symptom can be associated with FTD?
motor neuron disease
What other diseases are associated with FTD?
corticobasal syndrome and progressive supranuclear palsy syndrome
What is the KEY technological feature of FTD?
asymmetirc focal frontotemporal lobe atrophy
Parkinson’s diseasea dementia
when dementia occus after diagnosis of parkinson’s disease
dementia and neuropsychiatric syndrome precede or co-emerge with the parkinsonism
called DLB
What may indicate a PDD or DLB instead of just parkinson’s?
a hallucinatory delirium induced by L-DOPA
What is the major difference between DLB and AD?
DLB features relative presentation of memory but more severe visuospatial and executive deficits than seen in patients with early AD
Treatment for DLB?
cholinesterase inhibitor
what is the key feature of DLB?
Lewy bodies
what are Lewy bodies?
intraneuronal cytoplasmic inclusion that stain with PAS and ubiquitin; identified with antibodies to the presynaptic protein alpha-synuclein
identify: acquire deterioration in cognitive abilities that impairs the successful performance of activities of daily living.
dementia
which area is affected first in Alzheimer’s disease?
parahippocampal formation, which is the memory center
in Alzheimer’s disease, what is major neurotransmitter deficit and origin?
ACh and nucleus basalis of Meynert
“cholinergic hypothesis” is rational for treatment with?
donepezil, rivastigmine, galantamine
what is the clinical presentation of dementia with Lewy bodies?
dementia, looney as a tooney, bradykinesia and Parkinsonism
spells of unresponsiveness, supersensitive to neuroleptics
major cholinergic deficit
what is the initial molecular defect in DLB?
alpha-synuclein protein misfolding
what is the molecular defect in FTD?
tauopathy (mutation of tau protein)
what is the initial presentation of dementia?
dementia with Parkinsonism and visual hallucinations
what imaging technique can be used to differentiate between Alzheimer’s disease and frontotemporal dementia?
PET scan with radioligands
what is a black box warning for using neuroleptics in elderly patient with dementia?
cardiovascular risks
