Neurocognitive

Question 1

delirium

Answer 1

disturbance in attention and awareness and change in cognition that develop rapidly over short period

Question 2

delirious speech

Answer 2

rambling, irrelevant, pressure, incoherent and unpredictably switches from subject to subject

Question 3

onset of delirium

Answer 3

brief - rarely more than one month

symptoms usually diminish over 3-7 day period, up to 2 weeks

Question 4

factors affecting risk of delirium

Answer 4

system infection
febrile illness
metabolic DO - hypoxia, hypercarbia, hypoglycemia
hepatic encephalopathy
head trauma
seizure
migraine
brain abscess
stroke
postop states
electrolyte imbalance

Question 5

aphasia

Answer 5

inability to speak

Question 6

apraxia

Answer 6

inability to carry out motor activities

Question 7

confabulation

Answer 7

creating imaginary events to fill in memory gaps. usually in mild to moderate cognitive decline

Question 8

sun downing

Answer 8

symptoms seems to worsen in the late afternoon and evening

Question 9

stages of major NCD

Answer 9

1. no sx
2. forgetfulness
3. mild cognitive decline
4. mild to moderate decline - forget major events, declining ability to perform tasks, confabulation
5. moderate decline - lose ability to perform some ADL, disorientation, loss of names, addy. frustration and w/d from others
6. moderate to severe - incontinence, wandering, insomnia, disorientation, ADL only with assistance, agitation and aggression, sun-downing.
7. severe decline - bedfast, aphasic, no recognition, decubiti, contractures

Question 10

onset of AD

Answer 10

slow and insidious

Question 11

etiology of AD

Answer 11

1. ach alterations - decrease
2. plaques and tangles (amyloid beta and tau protein)
3. head trauma
4. genetic factors

Question 12

Pick’s DO

Answer 12

shrinking of the frontal and temporal anterior lobes of the brain
genetic etiology?

Question 13

Pick’s sx

Answer 13

2 patterns:

1. behavioral and personality changes - inappropriate, lack of judgement and inhibition. repetitive compulsive beh.
2. speech and language problems - difficulty understanding written and spoken

Question 14

which sx if most common following head trauma

Answer 14

amnesia

Question 15

dementia pugilistica

Answer 15

syndrome characterized by emotional lability, dysarthria, ataxia and impulsivity

Question 16

lewy body sx

Answer 16

rapid progression

earlier appearance of visual hallucination and parkinsonian features

Question 17

lewy bodies

Answer 17

eosinophilic inclusion bodies seen in cerebral cortex and brainstem

Question 18

ataxia

Answer 18

motor incoordination

Question 19

huntington’s sx

Answer 19

involuntary twitching of limbs or facial muscles
mild cog changes
depression
occurs between 30 and 50
ataxia

Question 20

prion sx

Answer 20

rapid progression
insidious onset
motor features of prion dz - myoclonus, ataxia, biomarker
involuntary movements
muscle rigidity
40-60 years

Question 21

psuedodementia

Answer 21

depression

Question 22

meds for cog impairment

Answer 22

donepezil (aricept)
revastigmine (exelon)
Galantamine (razadyne)
memantine (namenda)

Question 23

meds for agitation

Answer 23

olanzapine (zyprexa)
quetiapine (seroquel)
Haloperidol (haldol)
risperidone (resperidal)

Question 24

which med for cog impairment is an NMDA receptor agonist

Answer 24

memantine (namenda)

Question 25

anomia

Answer 25

decreased ability to remember words

Question 26

agraphia

Answer 26

inability to express thoughts in writing

Question 27

alexia

Answer 27

inability to understand written language

Question 28

agnosia

Answer 28

loss of ability to recognize objects

Question 29

causes of delirium

Answer 29

``` infectious withdrawal/intoxication acute metabolic trauma CNS abn hypoxia deficiency B12, niacin, thiamine endocrinopathy - adrenal, thyroiditis, uncontrolled DM acute vascular - HTN encephalopathy, shock, vasculitis, CNS SLE toxins/drugs heavy metals ```

Question 30

sx of AD

Answer 30

``` judgement orientation memory loss affect changed cognitive ability changed ```

Question 31

parkinson's etiology

Answer 31

loss of nerve cells and decrease of DA activity | imbalance between DA and Ach

Question 32

chorea

Answer 32

quick jerky purposeless involuntary movement

Question 33

korsakoff's

Answer 33

amnesia d/t ETOH, short term memory d/t hippocampus damage

Question 34

wernicke's encephalopathy

Answer 34

ETOH related characterized by ataxia, 6th CN palsy, nystagmus, confusion tx with thiamine

Question 35

pseudodementia sx

Answer 35

``` rapid progression forgetful oriented variable tasking sx better as day progresses distressed affect diminished appetite intact attention ```