Geri_EO

Question 1

What’s the proportion of NCD-mild that progresses to Alzheimer?

Answer 1

5-10% per year

75-80% at 10 years

Question 2

What is the only recommendation with evidence to prevent NCD?

Answer 2

Treat HTA (if >160, aim for <140mmHg)

Question 3

What are the stages and thresholds of the Global deterioration scale?

Answer 3

Stage 1 normal
Stage 3 NCD-mild
Stage 4 NCD-major
Stage 7 incontinent, needs assistance for all ADLs

Question 4

what is the Ddx of NCD?

Answer 4

AD
Vascular
Lewy body
FTD
HIV
TBI
PD
Huntington
Prion disease (creutzfeld-Jakob)
Etoh
NPH
MS
Other

Question 5

Triad of NPH

Answer 5

Ataxia
Cognitive decline
Incontinence

Question 6

What can mimic NCD?

Answer 6

NOT immobilisation

Hospitalisation, fecaloma, visual-auditive deficit

Pseudodementia: MDD - abrupt onset, rapid progression, Past psych Hx, Loi de ribot non applicable (ie baisse de mémoire récente avec préservation des souvenirs anciens)

Question 7

Give etiopatho of each type of NCD

Answer 7

1) proteinoathies (neurodegenerative)
- AD: TAU, amyloid plaques, neurofibrillary tangles)
- FTD: TAU, TDP-34, ubiquitine
- BLD: alpha-synucleine
- Dementia pugilistica: TAU, amyloid plaques, neurofibrillary tangles)
- Huntington: huntingtine

2) repeated insults
- vascular:
- Etoh or other substance
- HIV
- Infections

Question 8

Under which condition should you order brain imaging ?

Answer 8

<60yo
Rapide decline (1-2 mo)
Recent TBI
Non-explained neurological sx 
ATCD neoplasia
Dementia for less than 2 yrs
AC or trouble de la coagulation
Suden onset of incontience or diff walking

Question 9

In which case you can do genetic investigation?

Answer 9

<65 yo & fam Hx

Cmz 1 = preseniline 2
Cmz 14 = preseniline 1
Cmz 21 = APP

Question 10

What are the thresholds of MMSE?

Answer 10

> 18-26 light
10-18 moderate
<10 severe

Question 11

What’s the gold standart for NCD-mild?

Answer 11

MOCA. - more sensitive than MMSE (100% for AD); more. Specific than MMSE (87% vs 82%)

In MOCA, add a point if <13 years of schooling

Question 12

Which region we test with Luria serie?

Answer 12

Frontal

Question 13

What is the relationship with caudate and movement?

Answer 13

If hyperactivity of caudate = bradykinesia

If reduced activity: OCD, Tics

Question 14

What does the right equivalent of wernicke area ?

Answer 14

Understand emotions in others’ discourse

Right temporal lobe, superio-posterior

Question 15

Where is the lesion in anosognosie?

Answer 15

Non-dominant parietal (right for 99% of righty and 2/3 of lefty

Question 16

In which type of aphasia the patient does not know he has a problem?

Answer 16

Wernicke

Question 17

What is the D-KEFS verbal fluency test?

Answer 17

Name as many words that start with a letter, name as many words in a catégory
For task initiation

Question 18

What is the wisconsin card sorting test and trail making test part b for?

Answer 18

Cognitive flexibility - trail making test is the best for driving capacity

Question 19

What is the rey-osterrieth complex figure test

Answer 19

Copy complex figure, than draw it by recall

For planification

Question 20

what is the tower of london test

Answer 20

For planification

14 cards that tell you how the colored donuts should be on 3 sticks of different lenghts

Question 21

What is the WAIS-III similarities

Answer 21

For the reasoning - IQ test

Question 22

What is the stroop color and word test

Answer 22

Behavioral inhibition

Written color name differs from color ink it is printed in and tge patient must say the written word

Question 23

What is the main risk factor of AD?

Answer 23

1-Advanced age

Other risk factors are:
Female, fam hx, low schooling, HTA, Db, past MDE, past TBI, down syndrome, high level of homocysteine,

Question 24

What are the genes associated with late onset of AD? And early onset AD?

Answer 24

Late onset
E4/Ex allele : RR 3
E4/E4 allele: RR 8

early onset, onlu 6-7% of cases (13% of those have a familiale pattern)
Presinilin 1 on cmz 14 (30-70%) et 2 (5%) on cmz 1)
APP (amyoid protein precursor) (10-15%) on cmz 21

Question 25

Most common type of hallucinations in AD?

Answer 25

Visual

Question 26

What do you need to know about Binswanger disease?

Answer 26

Type of vascular dementia
Subcortical
Slow progressive
Pseudobulbar and parkinsonism elements
Typically in patients chronically HTA
Incontinence and fluctuation of cognition can happen

Question 27

What are the main caracteristics of BLD?

Answer 27

1- fluctuating presentation of sensorium and cognition
2- well formed visual hall
3- cognitive decline prior or at same time of parkinsonism

Question 28

What is the most common type of hallucination in Parkison?

Answer 28

Visual

Question 29

Name 4 types of Parkinson plus syndrom?

Answer 29

1-PSP (progressive supranuclear palsy) - rigidité axiale
2-Corticobasal degenerescence - frontal, syndrome du memebre étranger
3-multisystemic atrophy: syndrome cerebelleux
4- LBD

Alpha-synucliopathies in cortical and subcortical regions

Question 30

Name the 3 variant of frontotemporal dementia?

Answer 30

1-behavioral (50%) more frequent in male
Deshinibition, lack of empathy, apathie, stereotyped behavior/ritualistic/compulsive, hyperorality

2-language variant (primary progressive aphasia) (50%)
subtypes:
-semantic: word comprehension, more male
-non-fluent: speech production, more female
-logopenic