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export_dementia Flashcards

1
Q

Dementia

A

-Impairment in 2/5 functional domains–memory, emotion, executive, language, visuospatial—that effects activities of daily living ( ADLs) - Distinguished from delirium by lack of fluctuating course

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2
Q

Mild Cognitive Impairment

A

-Does not meet dementia criteria bc there was no impairment in function -risk factor for progression to dementia is 15% (10x normal population)

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3
Q

Alzheimer’s Disease -Criteria

A

->65 - Abnormal results on cognitive screening and neuropsychological tests - Deficits in >=2 cognitive domains -Progression over time -No disturbances of consciousness -40-90 y/o no other brain disease

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4
Q

Alzheimer’s Disease-Patho

A

-Extracellular amyloid plaques and intracellular tangles of tau protein -Family history: amyloid precursor -Increased risk with more apolioprotein e4 alleles _associated with Downs

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5
Q

Dementia w/ Lewy Bodies

A

-Prominent visual hallucinations -Parkinsonianism - Fluctuating concentration and attention * (differentiates from PD) - Same path as Parkinson’s Sleep disturbances and hypotension -A-synuclein

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6
Q

Frontotemporal Dementia

A

3rd most common - behavioral disinhibition, personal hygiene, apathy, or the progressive loss of language function; memory ok; younger age -2 patterns: apathy, abulia, mutism or dish inhibition, poor judgement, and antisocial behavior

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7
Q

Huntington’s Disease

A

AD -CAG repeats on chromosome 4 -Chorea,dementia, and death in 15 yrs

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8
Q

Huntington’s disease-radiology

A
  • -Boxcar ventricles ( atrophy of caudate head)
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9
Q

Progressie Supranuclear Palsy (PSP)

A

-Dementia, rigidity, loss of vertical eye movements, and devastating falls early in disease course

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10
Q

Progressie Supranuclear Palsy-Radiology

A

-Hummingbird sign =atrophy of midbrain

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11
Q

Dementia workup

A
  1. Look for reversible modifiable cause ( 10% of its)-BMP, renal function, TSH, serology for syphilis, B12, UA, tox screen, HIV test. 2. Neuroimaging if others unrevealing (MRI in all dementia patients at least once)
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12
Q

Metabolic Causes of Dementia

A

-Na (central pontine myelonosis) -Glucose -Ca2+ (deposits) -Hepatic encepalopathy -Renal Failure -Copper-in basal ganglia

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13
Q

Endocrine causes of Dementia

A

-Thyroid -PTH

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14
Q

Infectious causes of dementia

A

-Syphilis -HIV-white matter hyper density w.o mass effect -Herpes encephalopathy-hemorrhagic necrosis of inferior frontal and temporal ( asymmetric) -PML-diffuse white matter disease

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15
Q

Vitamin causes of dementia

A

-B12-dorsal columns; NO -Thiamine-Wernicke’s->atrophied mammillary bodies

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16
Q

Toxins->dementia

A

Drugs-heroine, CMO Medications

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17
Q

Normal Pressure Hydrocephalus

A

-Wet, wobbly, wacky -May be consequence of previous pathology in subarachnoid space (SAH, meningitis) -

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18
Q

Normal Pressure Hydrocephalus-TX/complications

A

-Shunt - candidates–presence of etiology on imaging, gait difficulties>cognitive imp, substantial improvement with removal of CSF, and lack of atrophy and white matter lesions -May get SDH

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19
Q

Vascular Dementia

A

-Step-wise; focal deficits -RF: HTN, DM, smoking, lipids -hippocampus/medial thalamus, caudate nucleus -Often with other dementing processes

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20
Q

Limbic/Paraneoplastic Encephalitis

A

-Young -Rapid -Prominent psych symtoms - Ovarian teratomas common in young females

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21
Q

CJD

A

-Rapidly progressive -FATAL-no intervention helps -Prion->spongiform changes -MRI: increased signal in BG and thalamus -Prion disease

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22
Q

Neuro-psych when…

A

-Help distinguish depression -Differentiate dementias -Helps identify strengths/weaknesses to guide tx

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23
Q

LP, EEG, SPECT/PET

A

Red flags: rapid dementia, IC host, focal neuro/ movement disorders, signs of systemic illness

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24
Q

Alzheimer treatment- Early

A

cholinesteraseinhibitors

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25
Charles Bonnet Syndrome
-Mentally healthy, significant visual loss - typical hallucinations include small animals and people -Understand hallucinations not real
26
Ganser syndrome
-"syndrome of approximate answers"
27
Kluver Bucy
-Bilateral amygdalae lesion - hypersexuality, plaicidity, hyperphagia/hyperorality, and visual agnosia.
28
Wernike-Korsakoff syndrome
-Necrosis of mamillary bodies -From chronic alcohol - def of Thiamine/B1 -Confabulation-making false memories -Changes of mental status from IV glucose
29
Wernike-Korsakoff syndrome-sx
ataxia, encephalopathy,eye movement abnormality
30
Transient Global Amnesia
-complete/reversible -no tx -migraine phenomenon -emotional event/ sexual activity
31
CJD dx
ESP signs like hypokinesia and cerebellar manifestations like nystagmus and ataxia -MRI, LP CSF and look for 14-3-3 and phosphorylated tau. Brain bx =GS
32
Pick's disease
Disinhibition, apathy, language disturbances. \< 65 and also memory relatively unaffected More rapid progression
33
Limbic encephalitis
Lung but in young females due to ovrin teratomas
34
-Impairment in 2/5 functional domains--memory, emotion, executive, language, visuospatial---that effects activities of daily living ( ADLs) - Distinguished from delirium by lack of fluctuating course
Dementia
35
-Does not meet dementia criteria bc there was no impairment in function -risk factor for progression to dementia is 15% (10x normal population)
Mild Cognitive Impairment
36
-\>65 - Abnormal results on cognitive screening and neuropsychological tests - Deficits in \>=2 cognitive domains -Progression over time -No disturbances of consciousness -40-90 y/o no other brain disease
Alzheimer's Disease -Criteria
37
-Extracellular amyloid plaques and intracellular tangles of tau protein -Family history: amyloid precursor -Increased risk with more apolioprotein e4 alleles \_associated with Downs
Alzheimer's Disease-Patho
38
-Prominent visual hallucinations -Parkinsonianism - Fluctuating concentration and attention \* (differentiates from PD) - Same path as Parkinson's Sleep disturbances and hypotension -A-synuclein
Dementia w/ Lewy Bodies
39
3rd most common - behavioral disinhibition, personal hygiene, apathy, or the progressive loss of language function; memory ok; younger age -2 patterns: apathy, abulia, mutism or dish inhibition, poor judgement, and antisocial behavior
Frontotemporal Dementia
40
AD -CAG repeats on chromosome 4 -Chorea,dementia, and death in 15 yrs
Huntington's Disease
41
- -Boxcar ventricles ( atrophy of caudate head)
Huntington's disease-radiology
42
-Dementia, rigidity, loss of vertical eye movements, and devastating falls early in disease course
Progressie Supranuclear Palsy (PSP)
43
-Hummingbird sign =atrophy of midbrain
Progressie Supranuclear Palsy-Radiology
44
1. Look for reversible modifiable cause ( 10% of its)-BMP, renal function, TSH, serology for syphilis, B12, UA, tox screen, HIV test. 2. Neuroimaging if others unrevealing (MRI in all dementia patients at least once)
Dementia workup
45
-Na (central pontine myelonosis) -Glucose -Ca2+ (deposits) -Hepatic encepalopathy -Renal Failure -Copper-in basal ganglia
Metabolic Causes of Dementia
46
-Thyroid -PTH
Endocrine causes of Dementia
47
-Syphilis -HIV-white matter hyper density w.o mass effect -Herpes encephalopathy-hemorrhagic necrosis of inferior frontal and temporal ( asymmetric) -PML-diffuse white matter disease
Infectious causes of dementia
48
-B12-dorsal columns; NO -Thiamine-Wernicke's-\>atrophied mammillary bodies
Vitamin causes of dementia
49
Drugs-heroine, CMO Medications
Toxins-\>dementia
50
-Wet, wobbly, wacky -May be consequence of previous pathology in subarachnoid space (SAH, meningitis) -
Normal Pressure Hydrocephalus
51
-Shunt - candidates--presence of etiology on imaging, gait difficulties\>cognitive imp, substantial improvement with removal of CSF, and lack of atrophy and white matter lesions -May get SDH
Normal Pressure Hydrocephalus-TX/complications
52
-Step-wise; focal deficits -RF: HTN, DM, smoking, lipids -hippocampus/medial thalamus, caudate nucleus -Often with other dementing processes
Vascular Dementia
53
-Young -Rapid -Prominent psych symtoms - Ovarian teratomas common in young females
Limbic/Paraneoplastic Encephalitis
54
-Rapidly progressive -FATAL-no intervention helps -Prion-\>spongiform changes -MRI: increased signal in BG and thalamus -Prion disease
CJD
55
-Help distinguish depression -Differentiate dementias -Helps identify strengths/weaknesses to guide tx
Neuro-psych when...
56
Red flags: rapid dementia, IC host, focal neuro/ movement disorders, signs of systemic illness
LP, EEG, SPECT/PET
57
cholinesteraseinhibitors
Alzheimer treatment- Early
58
-Mentally healthy, significant visual loss - typical hallucinations include small animals and people -Understand hallucinations not real
Charles Bonnet Syndrome
59
-"syndrome of approximate answers"
Ganser syndrome
60
-Bilateral amygdalae lesion - hypersexuality, plaicidity, hyperphagia/hyperorality, and visual agnosia.
Kluver Bucy
61
-Necrosis of mamillary bodies -From chronic alcohol - def of Thiamine/B1 -Confabulation-making false memories -Changes of mental status from IV glucose
Wernike-Korsakoff syndrome
62
ataxia, encephalopathy,eye movement abnormality
Wernike-Korsakoff syndrome-sx
63
-complete/reversible -no tx -migraine phenomenon -emotional event/ sexual activity
Transient Global Amnesia
64
ESP signs like hypokinesia and cerebellar manifestations like nystagmus and ataxia -MRI, LP CSF and look for 14-3-3 and phosphorylated tau. Brain bx =GS
CJD dx
65
Disinhibition, apathy, language disturbances. \< 65 and also memory relatively unaffected More rapid progression
Pick's disease
66
Lung but in young females due to ovrin teratomas
Limbic encephalitis

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