Neurocognitive Disorders

Question 1

Delirium (Sx)

Answer 1

-Disturbance in awareness and alertness
-1 other cognitive symptom
-Sx fluctuate in severity over the course of the day

Question 2

6 Cognitive Domains

Answer 2

SPECLL

-Social Cognition
-Perceptual motor
-Executive functioning
-Complex attention
-Language
-Learning & memory

Question 3

Alzheimer’s (Onset, Sx and stages)

Answer 3

-Onset is insidious

-Mild (impairment in 1 cognitive domain)
-Major (impairment in 2 or more cognitive domains)
*Decline in memory and/or learning

Early stage (2 to 4 years)
-STM loss (FIRST sx)
-Anomia
-Anxiety & depression
-Impaired attention
- Poor judgement
-Disorientation to time and space

Middle stage (2 to 10 years)
-LTM loss
- Greater STM loss
-Delusions & Hallucinations
-Labile mood
-Irritability
-Disorientation
-Disruptive speech

Late stage (1 to 3 years)
-Severe cognitive deterioration
-Apathy
-Impaired communication
- Aggression
-Incontinents
- Loss of basic motor skills
-Seizures

Question 4

Lewy Bodies (onset, sx, features)

Answer 4

-Onset is gradual

-fluctuating cognition
-visual hallucinations
-sx of parkinsonism

-REM sleep behavior disorder
-neuroleptic sensitivity

SX
-deficits in complex attention
-deficits in visual spatial
-deficits in executive functioning

*Cognitive deficits come before or around the same time as motor deficits.

Question 5

Vascular NCD (Sx, onset, causes)

Answer 5

Due to stroke or other neurovascular causes.

Sx
-decline in complex attention
-decline in executive functioning

Onset
- acute
-Stepwise decline (gradual at first and then progresses fast)

Causes
-hypertension
-heart disease
-diabetes
-obesity
-high cholesterol
-heavy cigarette smoking

Question 6

HIV infection NCD (Sx and area of brain)

Answer 6

Damage to subcortical area of the brain

Sx
-forgetfulness
-impaired attention/concentration
-psychomotor retardation
-clumsiness
-tremors
-apathy
-social withdrawal

Question 7

NCD due to Prion Disease (onset, progression, sx, causes)

Answer 7

Onset
-insidious

Progression
-rapid

*Creutzfeldt-Jakob Disease
-confusion
-disorientation
-impaired memory & judgement
-ataxia
-myoclenus (twitching)
-chorea

types
-sporadic = unknown
-family = inherited
-acquired - infected meat consumption

Question 8

Frontotemporal NCD (onset, types, subtypes)

Answer 8

*Most common early onset

1.Behavioral variant
-decline in social cognition
-decline in executive functioning

2. Language variant
   -decline in speech / language
   -anomia
   -speech difficulties
   -grammar
   -word comprehension
   *Primary progressive Aphasia
   1. semantic
   2. agramatic/nonfluent
   3. Logopenic (repetition of phrases or difficulty
   finding the right word.