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OMS - 2 Neuro Final > Neurocognitive Disorders 2 > Flashcards

Neurocognitive Disorders 2 Flashcards

1
Q

Causes of neurocognitive disorders (2)

A
  1. neurodegenerative
  2. vascular
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2
Q

Endocrine causes of neurocognitive disorders (5)

A
  1. DM
  2. Thyroid
  3. Parathyroid
  4. Cushings
  5. Addisons
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3
Q

Vitamin deficiency causes of neurocognitive disease (2)

A
  1. Vit B12
  2. Thiamine
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4
Q

Systemic disease that can lead to neurocognitive disorder (2)

A
  1. severe respiratory disease
  2. anemia
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5
Q

What labs are ordered to evaluate neurocognitive disorder (6)

A
  1. CBC
  2. Chem panel
  3. TFTs
  4. B12/Folate
  5. UA
  6. RPR or VDRL: HIV
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6
Q

AD8 questionnaire

A
  1. judgement
  2. lost interest
  3. repeats things
  4. trouble learning to use gadgets
  5. forget month or year
  6. financial affair difficulty
  7. can’t remember appointments
  8. daily problems w/thinking/memory

(2 or more = cognitive impairment)

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7
Q

AD risk factors (5)

(other than age, FMHx & Head injury)

A
  1. depression/bipolar
  2. HTN
  3. cerebrovascular disease
  4. less intellectual activity
  5. too much or too little sleep (<4; >10)
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8
Q

MC location: Senile/neuritic amyloid plaques (2)

A
  1. hippocampus
  2. neocortex
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9
Q

Amyloid precursor proteins (APP) extend across both sides of cell membranes and are cleaved by ______.

A

secretases (alpha, beta, gamma)

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10
Q

Which type of APP is deposited as amyloid?

A

Abeta42 (less soluble)

(Abeta40 is more soluble)

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11
Q

For alzheimer diagnosis, the patient must have one or both of the following AD causative genetic mutation AND/OR all 3: _________.

A
  1. decline in memory/learning + one other cognitive domain
  2. steady progression of gradual decline in cognition, no extended plateaus
  3. no mixed etiology
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12
Q

Behavioral symptoms of AD (4)

A
  1. irritability, anxiety and depression
  2. sleep disturbance
  3. agitation, restless
  4. delusions, hallucinations
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13
Q

Delusions and hallucinations seen in AD (5)

A
  1. phantom borders
  2. caregiver misidentification
  3. think their spouse is cheating
  4. think people are stealing their stuff
  5. think they’re being poisoned
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14
Q

Hereditary (familial) Alzheimer is uncommon. What is the mode of transmission?

A

AD

(most are sporadic)

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15
Q

Loci for familial alzheimers is _______ (3); loci for sporadic alzheimers is _______.

A
  • Chromosome 21, 14, or 1
  • Chromosome 19
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16
Q

Familial Alzheimer gene mutations (2)

A
  1. APP
  2. Preseninlin I & II
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17
Q

Sporadic Alzheimer gene mutations

A

ApoE 4

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18
Q

Underlying diseases that can be controlled to prevent AD (3)

A
  1. HTN
  2. cholesterol
  3. DM
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19
Q

Low vitamin D is associated with _______

A

memory, attention and logic problems

(quadruple the risk)

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20
Q

Treatment of AD may improve ______ and slow _______.

A
  • memory
  • deterioration
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21
Q

Aggression/agitation in Alzheimer patients may be treated with ______ (2).

A
  1. mood stabilizer
  2. antipsychotic
22
Q

Sundowning

A

agitation w/disorientation & confusion in the evening hours

23
Q

Sundowning treatment (4)

A
  1. increase daytime light exposure
  2. increase daytime activity; reduce naps
  3. avoid long-acting Rx
  4. short-acting hypnotics (trazadone, mirtazapine)
24
Q

Why are second generation antipsychotics preferable in treating AD?

A

less risk of tardive dyskinesia & EPS

25
Q

Risk factors leading to higher mortality in AD (2)?

A
  1. cancer
  2. NG tube placement

(UTI, CKD, MI are high risk factors also)

26
Q

vascular neurocognitive disorders are prominent in ______ and ______ function

A
  • complex attention
  • executive
27
Q

Define pseudobulbar palsy

A

difficulty controlling facial movements

28
Q

Vascular NCD clinical features (4)

A
  1. gait/frequent falls
  2. urinary frequency/urgency
  3. pseudobulbar palsy
  4. personality/mood changes
29
Q

Lewy Body NCD onset & progression

A
  • insidious
  • gradual
30
Q

Probable NCD w/Lewy Body is ________; Possible NCD w/Lewy Body is ________.

A
  • 2 core features or 1 core + 1 suggestive
  • 1 core feature or 1 + suggestive
31
Q

Core dx features of NCD w/Lewy Body (3)

A
  1. Fluctuating cognition (attention & alertness)
  2. Hallucination
  3. Parkinsonism

(suggestive features: sleep disorder or neuroleptic sensitivity)

32
Q

2 variants of frontotemporal disorder

A
  1. behavioral
  2. language
33
Q

Behavioral symptoms of the behavioral variant of frontotemporal disorder (4)

A
  1. disinhibition
  2. hyperorality
  3. apathy
  4. loss of sympathy
34
Q

Language symptoms in language variant of frontotemporal disorder (3)

A
  1. decline in language ability & comprehension
  2. word finding
  3. object naming
35
Q

In general, frontotemporal disorder spares _______ (2)

A
  1. language & memory
  2. perceptual-motor
36
Q

All NCD show agitation & aggressiveness, except for _______.

A

frontotemporal

37
Q

Delusions & hallucinations are most prominent in _______ (NCD)

A

Lewy Body

38
Q

Anxiety/Depression is most prominent in ______(NCD).

A

Vascular

(then LB & AD)

39
Q

Apathy is most prevalent in _______ (2 NCD)

A
  1. frontotemporal
  2. vascular
40
Q

Altered sleep is most prevalent in _______(NCD)

A

frontotemporal

41
Q

Sexual disinhibition is most prominent in _______ (NCD).

A

frontotemporal

42
Q

TBI may lead to NCD if one or more of the following are present: (4)

A
  1. LOC
  2. posttraumatic amnesia
  3. disorientation/confusion
  4. neurological signs
43
Q

NCD due to prion disease symptoms

A

myoclonus or ataxia

44
Q

Signs of NCD due to depression (3)

A
  1. lack of effort and “I don’t know”
  2. impaired attention
  3. impaired speed of info processing

(patient aware of sx; improves w/depression tx)

45
Q

How are schizophrenia sx different from NCD?

A
  1. complex delusions
  2. suicidal ideation
  3. hx of psychosis

(this is the opposite of NCD)

46
Q

Wernicke’s encephalopathy sx (3)

A
  1. confusion
  2. opthalmoplegia
  3. ataxia
47
Q

Korsakoff syndrome sx (2)

A
  1. anterograde & retrograde amnesia
  2. confabulation
48
Q

Alcohol-related neurocognitive disorder sx (3)

A
  1. memory impairment
  2. frontal lobe deficits
  3. ataxia
49
Q

Frontal lobe deficits seen in alcohol-related cognitive disorders (3)

A
  1. disinhibition/aggression
  2. abstraction & planning difficulty
  3. apathy
50
Q

Most debilitating sx of long COVID (2)

A
  1. fatigue
  2. cognitive impairment
51
Q

Cognitive symptoms of long COVID: difficulty with ______ (4).

A
  1. planning & decision making
  2. cognitive processing speed
  3. attention & recall
  4. working & procedural memory

OMS - 2 Neuro Final (36 decks)

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