Neurocognitive Disease

Question 1

What are the pathological findings for Lewy body dementia?

Answer 1

Cortical Lewy bodies
Alpha-synuclein hyperphosphorylated

Neurite involvement shown on immunolanelling

May have some findings as in Alzheimer’s and Parkinson’s

Question 2

What are the pathogical findings of Alzheimer’s disease?

Answer 2

Minimal to severe brain atrophy

Question 3

What is the pathology of frontotemporal dementia?

Answer 3

Protein inclusions in cells cytoplasm and nucleus: tau, TDP-43, FUS

Question 4

What are the pathological findings of Ceuzfeldt-Jakob Disease?

Answer 4

Accumulation of prion protein (malformed into beta sheets)

Grossly: vacuolation /spongiform change in

Question 5

Delirium

Answer 5

Acute confusional state ( hours to days)
Characterized by lack of attention, disorganized thinking, altered level of consciousness

Due to medical cause

Question 6

What are the risk factors for developing delirium?

Answer 6

ADMISSION:

• visual impairment
• sever illness
• cognitive impairment
• dehyrdration

HOSPITAL

• physical restraints
• malnutrition
• more than 3 meds
• Catheter

PRE OP

• > 70
• EtOH abuse
• poor cognition
• poor function
• electrolyte abnomal
• thoracic surgery

Question 7

What features are suggestive of Lewy body dementia?

Answer 7

• major neurocognitive disorder
• visual hallucinations
• decreased attention, executive function
• decreased visual spatial skills
• fluctuating cognition
• Parkinsonism with decline
• REM sleep disorders

Question 8

What features are suggestive of Alzheimer’s?

Answer 8

• major neurocog disorder and gradual decline
• decreased memory and learning
• decreased cognition: language, abstract reasoning, executive function
• behavioural changes
• motor changes
• AGE!

Question 9

What features suggest frontotemporal dementia?

Answer 9

Behavioural:

• disinhibition
• apathy/inertia
• decreased sympathy/empathy
• hyperorality (binge eating)
• decreased insight
• perseveration, tapping

Language:
-decreased production, comprehension, word finding, naming, grammar

Motor:

• corticobasal degeneration
• progressive supra nuclear palsy

Question 10

Criteria for major neurocognitive disorder

Answer 10

Substantial cognitive decline in 1+ domains:
Social
Memory and learning
Motor
Speech and language 

Or
2 standard deviations below mean on major neurocognitive testing

Interfere with ADLs