Neurocognitive disorders Flashcards
What are the three broad categories of Amnestic Disorders?
- Amnestic disorder due to a general medical condition
- Susbtance-induced persisting amnestic disorder
- Amnestic disorder not otherwise specified (NOS)
What drug is used to treat psychosis in delirium? What is the effective total daily dose?
Haloperidol; Effective total daily dose is 5-40 mg
These are masses of cytoskeletal elements seen in some post-mortem specimens but are not necessary for diagnosis?
Pick bodies
Differentiate the memory characteristics in subcortical vs cortical dementia?
Subcortical: Impaired recall (retrieval), Not Recognition Encoding
Cortical: Recall and Recognition Impaired
The hallmark of delirium
impairment in consciousness,
occurring with global impairments of cognitive function
What is bradyphenia?
slow movements of persons with PD are parallel in the slow thinking of some affected patients
This reversible CNS disorder is characterized by an acute decline in the level of consciousness and cognition with particular impairment in attention
Delirium
What is S100B? What is its expected finding in delirium?
Calcium-binding protein involved in the regulation of a number of cellular processes, such as cell cycle progression and differentiation
• elevation in CSF
This type of dementia is also called Punch-Drunk Syndrome (Dementia Pugilistica) which occurs in boxers after repeated head trauma over many years; Enumerate its clinical features
Head Trauma-Related Dementia; (1) emotional lability, (2) dysarthria, and (3) impulsivity
Enumerate the impairments in dementia.
Visuospatial impairments
Memory impairments
What are the main abilities affected by dementia?
- Judgment
- Orientation
- Emotions
- Memory
- Thinking
Enumerate the neurotransmitter involvement in Alzheimer’s Disease.
Decreased concentration of Acetylcholine and Norepinephrine
• Cholinergic System degeneration with the significant loss of neurons in the certain areas (such as Nucleus Basalis of Meynert)
• Decreased concentration of neuroactive peptides somastatin and corticotrophin
Enumerate the psychiatric and neurologic changes in patients with dementia
Personality Hallucinations and delusions Mood (depression, anxiety) Catastrophic reaction Sundowner syndrome
T or F: divalproex is given in low doses for the elderly
T
How is the course of amnestic disorder different from that of Alzheimer’s dementia?
Alzheimer’s Disease – progressive deterioration
Amnestic Disorder – stasis or improvement
What comprises complex attention?
Sustained attention
• Divided attention
• Selective attention
• Processing speed
This is the second most common etiology of dementia?
Vascular Dementia
Differentiate transient and chronic amnestic disorder according to DSM-IV
Transient: memory impairment lasts for 1 month or less
Chronic: memory impairment lasts for >1month
What is the second diagnostic criterion for delirium in DSM-5?
The disturbance develops over a short period (usually hours to days), represents a change from baseline attention and awareness, and tends to fluctuate in severity during the course of the day.
The Alzheimer’s type of dementia has shown linkage to which chromosomes?
chromosomes 1, 14 and 21
This is the essential feature in patients with amnestic disorder
Impaired ability to learn and recall new information coupled with inability to recall past events
T or F: In treatment of delirium, psychiatric symptoms must be addressed before starting treatment of the underlying symptom.
F
How is the dementia in Huntington Disease different from Alzheimer’s Disease?
High incidence of depression and psychosis in addition to the classic choreoathetoid disorder
T or F: Visual hallucinations are more common in schizophrenia and depression than in delirium
F
What are the atypical antidepressants prescribed to depressed demented patients
Citalopram, fluoxetine, sertraline, trazodone
Describe Sundowner Syndrome
Characterized by drowsiness, confusion, ataxia and accidental falls; Occur in demented patients when external stimuli, such as light and interpersonal orienting clues, are diminished
This behavior approach in demented patients is used to recount pleasurable experiences
Reminiscence Therapy
Major neurotransmitter involved in delirium
Acetylcholine
Major anatomical area involved in delirium
Reticular Formation
Major pathway involved in delirium
Dorsal Tegmental Pathway
Which impairment in dementia is the first impairment noticed in highly educated/intelligent patients?
Executive Function
How is dementia distinguished from normal aging?
Normal aging not affect activities of daily living
Acetylcholinesterase Inhibitors are used for which type of symptoms in Mild to Moderate Alzheimer’s and dementia?
Cognitive Symptoms
What is Biswanger’s Disease?
Subcortical Arteriosclerotic Encephalopathy; characterized by the presence of many small infarctions of the white matter that spare the cortical regions
T or F: In pseudodementia, history of previous psychiatric dysfunction is unusual, whereas it is common in dementia.
F
When will lithium-induced delirium be resolved once lithium has been stopped?
Up to 2 weeks
