Neurocognitive disorders Flashcards
atrophy of the _________ is most prominent in AD
hippocampus
vascular disease / dementia is aka _________
binswanger’s disease or multi-infarct dementia
psychosis in LBD should be treated with _________ and NOT _______________
- cholinesterase inhibitors
- NOT antipsychotics
what are the features of FTD?
- younger (50s)
- language problems
- steadily progresses
HD has what inheritance pattern?
AD
how can NPH be treated? how is that assessed?
- ventriculo-paritoneal shunt
- LP
how is NPH diagnosed?
neuroimaging
what are 4 examples of static encephalopathy?
- traumatic brain injury
- hypoxic brain injury (cardiac arrest or CO)
- korsakoff’s syndrome
- post-infectious
what is the classic triad of wernicke’s encephalopathy ?
- delirium
- ocular changes
- gait disturbance
what is the main feature of cognition with korsakoff’s syndrome?
- cognition may improve (with drinking cessation) somewhat with extended sobriety, but then usually plateaus
- confabulations
how is lyme disease diagnosed, generally?
clinical presentation plus serology
what is the top priority treatment strategy for delirium?
identify and correct underlying cause
what is the one year mortality with delirium?
50%
what will neuro exam look like in a dementia patient?
nonfocal
what are the initial lab tests for dementia?
- CBC
- CMP
- B12
- thyroid studies
competency can only be determined by the _______
court
what is BPSD? what are the FDA treatments?
- behavioral and psychological symptoms of dementia
- NO FDA APPROVED TREATMENTS
what are the behavioral / psychological clusters?
- explosive
- psychotic
- manic
- depressive
- anxious
- confused
- oppositional
what are the targets for antidepressants?
- depressed
- anxious
- sexually inappropriate
what are the targets for benzos?
- PRN for anxiety or insomnia (avoid)
which medication class has a high mortality rate in dementia patients?
antipsychotics
donepezil, rivastigmine, and galantamine are what med class?
acetylcholinesterase inhibitors
memantine is what med class?
NMDA receptor antagonist (glutamate mediated)
