L11: PD, NPH, CJD, Memory Disorders

Question 1

Epidemeology of Parkinson Disease

Answer 1

About 50% of patients have dementia by 85 years old

Question 2

CP of Parkinson Disease

Answer 2

Question 3

CP of Parkinson Disease

• Symptoms

Answer 3

Question 4

Cause of Normal Pressure Hydrocephalus

Answer 4

Derangement of CS hydrodynamics

Question 5

CP o Normal Pressure Hydrocephalus

Answer 5

Question 6

INVx for Normal Pressure Hydrocephalus

Answer 6

CT shows ventricular enlargement with no evidence of cortical atrophy

Question 7

Management of Normal Pressure Hydrocephalus

Answer 7

• Therapeutic Lumbar Puncture
• Ventriculoperitoneal shunt

Question 8

Management of Normal Pressure Hydrocephalus

• Therapeutic Lumbar Puncture

Answer 8

Most important test

• Remove large amount of CSF.
• Examine gait and cognitive function.

Question 9

Management of Normal Pressure Hydrocephalus

• Ventriculoperitoneal Shunt

Answer 9

may correct if:

• Patients improve within minutes to hours of removal of 30:40 mL of CSF.
• Trauma or subarachnoid hemorrhage

Question 10

Age of Cruetzfeldt Jakob Syndrome

Answer 10

40- 75 years

Question 11

CP of Cruetzfeldt Jakob Syndrome

Answer 11

Question 12

CP of Cruetzfeldt Jakob Syndrome

• Myoclonus

Answer 12

90% has Myoclonus vs 10% in AD.

Question 13

CP of Cruetzfeldt Jakob Syndrome

• Dementia

Answer 13

Progressive dementia & personality changes over weeks to months

Question 14

Prognosis of CJD

Answer 14

Death <1 year from first symptom

Question 15

INVx for CP of Cruetzfeldt Jakob Syndrome

Answer 15

• EEG: Diffuse slowing and periodic sharp waves or spikes
• MRI: Basal ganglia abnormalities
• CSF: Detect specific amino acid sequence (PrPSc)

Question 16

Compare between delirium, Dementia & Depression

Answer 16

Question 17

Def of Pseudo-Dementia

Answer 17

Abrupt onset of Severe depression + Memory & language intact

Question 18

Symptoms of Pseudo-Dementia

Answer 18

Vegetative symptoms:
1. Insomnia
2. Anergy
3. Loss of Appetite

Question 19

Examples of Amnestic Disorders

Answer 19

• Aging
• Transient Global Amnesia
• Head injury
• Korsakoff Syndrome

Question 20

Examples of Amnestic Disorders

• Aging

Answer 20

Question 21

Examples of Amnestic Disorders

• Transient Global Amnesia

Answer 21

Question 22

Age of Transient Global Amnesia

Answer 22

Affects patients >50 years.

Question 23

Frequency of Transient Global Amnesia

Answer 23

Usually have only 1 episode, lasting 6 to 12 hrs.

Question 24

DDx of Transient Global Amnesia

Answer 24

• psychogenic amnesia
• fugue state
• partial complex status epilepticus.

Question 25

CP of Transient Global Amnesia

Answer 25

Question 26

Cause of Transient Global Amnesia

Answer 26

• May be due to vascular insufficiency to hippocampus or midline thalamic projections

Question 27

Examples of Amnestic Disorders

• Head Injury

Answer 27

Question 28

CP of Head Injury

• Amnesia

Answer 28

Retrograde amnesia › antegrade amnesia

Question 29

CP of Head Injury

Answer 29

• With time, memories usually return but rarely to recall events surrounding trauma

Question 30

Examples of Amestic Disorders

• Korsakoff

Answer 30

Question 31

CP of Korsakoff’s Syndrome

• Memory

Answer 31

• Near-total inability to establish new memory.
• Immediate memory NL, attention NL

Question 32

CP of Korsakoff’s Syndrome

• Confabulation

Answer 32

Patients confabulate about recent events.

Question 33

Initial Evaluation of Dementia

Answer 33

…

Question 34

Korsakoff’s Syndrome

• Most Common Cause

Answer 34

thiamine and other nutritional deficiencies with chronic alcoholism