Neurocognitive Disorder Flashcards
When does FTD typically occur?
Before age 60. It is a gradual process, not abrupt
Neurocognitive disorders and OSA
OSA can worsen the severity of NCDs. There is a clear link.
Most common EARLY alzheimers symptom
Apathy
Which is acetylcholinesterase inhibitor is approved for the treatment of anticholinergic delirium?
Physostigmine
Which test would show Most severe impairment in early NCD?
Weschler Memory Test
Which alz drug is contraindicated in severe renal and severe hepatic dz?
Galantamine
Trazodone and ALzq
Can be helpful if depression and insomnia are present.
Alzheimer’s patients with asthma should beware of which medications?
History of asthma or COPD potentially can experience increased airway reactivity following cholinergic stimulation by such cholinesterase inhibitors as donepezil, galantamine, Rivastygmine
Which cholinesterase inhibitor is the best in Alzheimer’s?
All are equal efficacy
Delirium is associated with a change in which neurotransmitter?
Decrease in acetylcholine
Normal aging of 75 yo
- decreased non-REM sleep
- under-reactive DTRs
- Decrease in brain weight to 85% of normal.
- Slowing of background alpha activity on EEG
AIDS dementia complex
AIDS dementia complex (sometimes also called HIV-associated dementia), which causes symptoms such as encephalitis (inflammation of the brain), behavioral changes, and a gradual decline in cognitive function.
Fluctuating cognition is which type of dementia?
Dementia with lewy body
Pt taking rivastigmine oral gets nausea, vomiting, and diarrhea. What do you do?
The gastrointestinal disturbance with acetylcholinesterase inhibitors comprises of nausea, vomiting, and diarrhea. The current recommendation of management is the conversion of oral rivastigmine to administration via a transdermal patch
What is the worse beta to deal with in Alzheimers?
Aβ1-42 is believed more prone to aggregation and possibly more pathogenic
MAPT gene mutation is what?
Frontotemporal dementia
Safe treatment for post operative delirium?
ondansetron
The 5% rule with 65
Starting at age 65, there is a 5%-8% rate of alzheimers. It goes up 5% every 5 years.
Visual hallucinations and donepezil
Actually has a chance to reduce visual hallucinations seen in LBD.
Best neuroimaging to differentiate alzheimers from FTD?
PET to check out glucose metabolism
Hepatic encephalopathy can cause which type of delirium?
Hypoactive
What scan can be given to differentiate parkinsons tremor for essential?
SPECT should be considered for people with tremor where essential tremor cannot be clinically differentiated from Parkinsonism.
First symptom to get hit by vascular NCD?
executive function
Late onset Alzheimers is associated with what?
Hypertension/cerebrovascular disease
What part of the brain is most often impacted in Alzheimer’s ?
Entorhinal cortex