Exam 4 - Neurocognitive Disorders Flashcards
The damage or destruction of brain tissue may involve a wide range of outcomes depending on:
- nature, location, and extent of neural damage
- premorbid competence and personality of individual
- individual’s life situation
- amount of time since the first appearance of condition
- level of function prior to the damage
In order to assess the clinical signs of brain damage, you can perform a mini-mental state examination, which includes:
- orientation
- registration
- attention and concentration
- recall
- language
- comprehension
- construction ability
Diffuse damage
damage to the entire brain
Focal damage
damage to a specific area of the brain
What is delirium?
- acute confusional state that lies between normal wakefulness and stupor or coma, incapable of any mental activity
- reflects major change in the way that the brain is working
- sudden onset, occurs at any age
- medical emergency
What are the treatments for delirium?
- most often treated by medications, environmental manipulations, and family support
- can be reversable
What is the clinical picture of dementia?
- also called major neurocognitive disorder
- characterized by a decline from a previously attained level of mental functioning - a marked neurocognitive decline
- slow onset and deteriorating course
- most commonly caused by Alzheimer’s disease
What is the clinical picture of Parkinson’s disease (symptoms, cause, treatment)?
- characterized by tremors or rigid movements (resting tremors)
- primarily caused by loss of dopamine receptors and damage to the substantia nigra
- given L-dopa for treatment (precursor for dopamine), and can also be given physical therapy
- not considered a dementia
What is the clinical picture of Huntington’s disease?
- chronic, progressive chorea (large, involuntary motor movements)
- rare degenerative disorder of the nervous system that causes a loss of neurons in the basal ganglia
- genetic
- dementia
- treatments include dopamine agonists
Alzheimer’s Disease
- progressive and fatal neurodegenerative disorder that causes dementia
- the main symptom is cognitive decline
What are the risk factors of Alzheimer’s?
- risk increases with age
- genetics
- genetic mutations of APP (amyloid precursor protein)
- the APOE-E4 allele of the APOE gene
- cardiovascular issues (chronic reduction of blood to the brain)
What is the characteristic neuropathology of Alzheimer’s?
- cell loss in hippocampus and basal forebrain
- amyloid plaques
- neurofibrillary tangles
What is the course of Alzheimer’s?
- destruction of cells that make acetylcholine, which is important for memory
- drug treatments include cholinesterase inhibitors (stops the breakdown of Ach) such as donepezil or aricept
- drugs help stop Ach from being broken down, and therefore increasing availability to the brain
What neurotransmitter do patients with Alzheimer’s lack?
Acetylcholine
Any comprehensive approach to therapeutic intervention must consider the situation of ________.
caregivers
