DSA 33 Dementia

Question 1

what is the difference between dementia and delirium?

Answer 1

delirium is an acute decline in cognition that fluctuates over hours/days

Question 2

potentially reversible dementia if discovered early

Answer 2

normal pressure hydrocephalus

Question 3

What are conditions that cause dementia?

Answer 3

NPH, Alzehimers, Parkinson’s dementia, and vascular dementia Frontotemporal Lobar Degeneration

Question 4

What does a patient with NPH have a history of?

Answer 4

head injury, meningitis, or subarachnoid hemorrhage

Question 5

pharmacology for AD?

Answer 5

donepezil, rivastigmine, galantamine, memantine which is not really good treatment

Question 6

What are the two types of vascular dementia?

Answer 6

multi-infarct dementia and diffuse white matter disease (Binswanger’s disease)

Question 7

What distinguishes the two types of vascular dementia?

Answer 7

MRI

Question 8

What are the three types of FTD?

Answer 8

behavioral variant and two forms of primary progressive aphasia (semantic and nonfluent/agrammatic variant)

Question 9

What major symptom can be associated with FTD?

Answer 9

motor neuron disease

Question 10

What other diseases are associated with FTD?

Answer 10

corticobasal syndrome and progressive supranuclear palsy syndrome

Question 11

What is the KEY technological feature of FTD?

Answer 11

asymmetirc focal frontotemporal lobe atrophy

Question 12

Parkinson’s diseasea dementia

Answer 12

when dementia occus after diagnosis of parkinson’s disease

Question 13

dementia and neuropsychiatric syndrome precede or co-emerge with the parkinsonism

Answer 13

called DLB

Question 14

What may indicate a PDD or DLB instead of just parkinson’s?

Answer 14

a hallucinatory delirium induced by L-DOPA

Question 15

What is the major difference between DLB and AD?

Answer 15

DLB features relative presentation of memory but more severe visuospatial and executive deficits than seen in patients with early AD

Question 16

Treatment for DLB?

Answer 16

cholinesterase inhibitor

Question 17

what is the key feature of DLB?

Answer 17

Lewy bodies

Question 18

what are Lewy bodies?

Answer 18

intraneuronal cytoplasmic inclusion that stain with PAS and ubiquitin; identified with antibodies to the presynaptic protein alpha-synuclein

Question 19

identify: acquire deterioration in cognitive abilities that impairs the successful performance of activities of daily living.

Answer 19

dementia

Question 20

which area is affected first in Alzheimer’s disease?

Answer 20

parahippocampal formation, which is the memory center

Question 21

in Alzheimer’s disease, what is major neurotransmitter deficit and origin?

Answer 21

ACh and nucleus basalis of Meynert

Question 22

“cholinergic hypothesis” is rational for treatment with?

Answer 22

donepezil, rivastigmine, galantamine

Question 23

what is the clinical presentation of dementia with Lewy bodies?

Answer 23

dementia, looney as a tooney, bradykinesia and Parkinsonism

spells of unresponsiveness, supersensitive to neuroleptics

major cholinergic deficit

Question 24

what is the initial molecular defect in DLB?

Answer 24

alpha-synuclein protein misfolding

Question 25

what is the molecular defect in FTD?

Answer 25

tauopathy (mutation of tau protein)

Question 26

what is the initial presentation of dementia?

Answer 26

dementia with Parkinsonism and visual hallucinations

Question 27

what imaging technique can be used to differentiate between Alzheimer’s disease and frontotemporal dementia?

Answer 27

PET scan with radioligands

Question 28

what is a black box warning for using neuroleptics in elderly patient with dementia?

Answer 28

cardiovascular risks