Geri_EO Flashcards
What’s the proportion of NCD-mild that progresses to Alzheimer?
5-10% per year
75-80% at 10 years
What is the only recommendation with evidence to prevent NCD?
Treat HTA (if >160, aim for <140mmHg)
What are the stages and thresholds of the Global deterioration scale?
Stage 1 normal
Stage 3 NCD-mild
Stage 4 NCD-major
Stage 7 incontinent, needs assistance for all ADLs
what is the Ddx of NCD?
AD Vascular Lewy body FTD HIV TBI PD Huntington Prion disease (creutzfeld-Jakob) Etoh NPH MS Other
Triad of NPH
Ataxia
Cognitive decline
Incontinence
What can mimic NCD?
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)
Give etiopatho of each type of NCD
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
Under which condition should you order brain imaging ?
<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
In which case you can do genetic investigation?
<65 yo & fam Hx
Cmz 1 = preseniline 2
Cmz 14 = preseniline 1
Cmz 21 = APP
What are the thresholds of MMSE?
> 18-26 light
10-18 moderate
<10 severe
What’s the gold standart for NCD-mild?
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
Which region we test with Luria serie?
Frontal
What is the relationship with caudate and movement?
If hyperactivity of caudate = bradykinesia
If reduced activity: OCD, Tics
What does the right equivalent of wernicke area ?
Understand emotions in others’ discourse
Right temporal lobe, superio-posterior
Where is the lesion in anosognosie?
Non-dominant parietal (right for 99% of righty and 2/3 of lefty
In which type of aphasia the patient does not know he has a problem?
Wernicke
What is the D-KEFS verbal fluency test?
Name as many words that start with a letter, name as many words in a catégory
For task initiation
What is the wisconsin card sorting test and trail making test part b for?
Cognitive flexibility - trail making test is the best for driving capacity
What is the rey-osterrieth complex figure test
Copy complex figure, than draw it by recall
For planification
what is the tower of london test
For planification
14 cards that tell you how the colored donuts should be on 3 sticks of different lenghts
What is the WAIS-III similarities
For the reasoning - IQ test
What is the stroop color and word test
Behavioral inhibition
Written color name differs from color ink it is printed in and tge patient must say the written word
What is the main risk factor of AD?
1-Advanced age
Other risk factors are:
Female, fam hx, low schooling, HTA, Db, past MDE, past TBI, down syndrome, high level of homocysteine,
What are the genes associated with late onset of AD? And early onset AD?
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
Most common type of hallucinations in AD?
Visual
What do you need to know about Binswanger disease?
Type of vascular dementia Subcortical Slow progressive Pseudobulbar and parkinsonism elements Typically in patients chronically HTA Incontinence and fluctuation of cognition can happen
What are the main caracteristics of BLD?
1- fluctuating presentation of sensorium and cognition
2- well formed visual hall
3- cognitive decline prior or at same time of parkinsonism
What is the most common type of hallucination in Parkison?
Visual
Name 4 types of Parkinson plus syndrom?
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
Name the 3 variant of frontotemporal dementia?
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
