Geriatrics

Question 1

What are the 6 cognitive domains?

Answer 1

1) language
2) learning and memory
3) executive ability
4) complex attention
5) perceptual motor
6) social cognition

LLEAPS

Question 2

What are the features of cortical dementia?

Answer 2

Cortical release signs
Language impairment - Aphasia
Perseveration
Disinhibition
Memory impairment
Agnosia
Apraxia
Impaired visuospatial construction

Question 3

What anatomic loci is cortical dementia associated with?

Answer 3

Neocortical association areas

Hippocampus

Question 4

What are the features of subcortical dementia?

Answer 4

Slowing in information processing
Reduced attention
Poor executive function
Poor visuospatial function
Emotional lability
Motor signs: pyramidal or extrapyramidal

Question 5

What anatomic loci is subcortical dementia associated with?

Answer 5

Thalamus
Basal ganglia
Rostral brain stem

Question 6

What are cortical dementias?

Answer 6

Alzheimer’s
FTD
Pick’s disease

Question 7

What are subcortical dementias?

Answer 7

Parkinson's disease
Huntington disease
Wilson disease
AIDS dementia
Progressive supranuclear palsy

Question 8

Which are mixed dementias?

Answer 8

Vascular dementia
Creutzfeldt-Jakob disease
Dementia due to trauma

Question 9

What are the main features of lewy body dementia?

Answer 9

Dementia
 visual hallucinations
parkinsonism
cognitive fluctuations
dysautonomia
sleep disorders
neuroleptic sensitivity

In addition to dementia, a patient with probable DLB must have at least two “core clinical features” of DLB: cognitive fluctuations, visual hallucinations, rapid eye movement (REM) sleep behavior disorder (RBD), and parkinsonism

Question 10

What are pathological findings in Lewy Body Dementia?

Answer 10

pathologic hallmark of DLB is the presence of eosinophilic intracytoplasmic inclusions called Lewy bodies, which contain aggregated alpha-synuclein, in the deep cortical layers throughout the brain, especially in anterior frontal and temporal lobes, cingulate gyrus, and insula.

Question 11

Ddx for falls with cognitive impairment?

Answer 11

Delirium
NPH
Li toxicity

Question 12

Early features for DLB?

Answer 12

DLB is characterized by early impairments in attention and executive and visuospatial function, with memory affected later in the course of the disease [3-9]. Early symptoms include driving difficulty (eg, getting lost, misjudging distances, or failing to see stop signs or other cars) and impaired job performance.