Neurocognitive disorders- exam 4

Question 1

what does delirium mean

Answer 1

• acute, short term, rapid onset
• disturbance of consciousness: memory, disorientation, perception, attention & awareness (cant focus, sustain, or shift attention)
• obviously due to a general medical condition or substance induced (medication, drug, or toxin)

Question 2

does the word ‘acute’ apply to neurocognitive disorders

Answer 2

no, they are long term and chronic

Question 3

how is delirium different from dementia

Answer 3

dementia is a neurocognitive disorder. people with dementia can have delirium but not everyone with delirium has dementia

Question 4

what is sundown syndrome

Answer 4

symptoms of dementia/neurocognitive disorder worsen at night

Question 5

what is ICU psychosis

Answer 5

patients in the ICU who develop delirium as a result of sensory isolation

Question 6

what is cognitive functioning in normal aging

Answer 6

The normal aging process is associated with declines in certain cognitive abilities, such as processing speed and certain memory, language, visuospatial, and executive function abilities

Question 7

what is crystalized intelligence vs. fluid intelligence

Answer 7

Fluid intelligence is your ability to process new information, learn, and solve problems. Crystallized intelligence is your stored knowledge, accumulated over the years. The two types work together and are equally important.

Question 8

how is recall different from recognition

Answer 8

Recognition refers to our ability to “recognize” an event or piece of information as being familiar, while recall designates the retrieval of related details from memory

Question 9

is recall or recognition more difficult in old age

Answer 9

recall

Question 10

what happens to processing speed and attention as one ages

Answer 10

A hallmark of cognitive aging is slowed processing speed, or a decrease in the rate at which people perform perceptual, motor, and decision making tasks.

Question 11

what is dementia; what are the primary signs and symptoms/DSM-5 criteria

Answer 11

multiple cognitive defects including:
- impairment in memory (multiple etiologies)
- function is impaired (interferes with indepence in daily activities)
- concern of a ‘knowledgeable informant’ or the individual of significant decline
- evidence of decline documented by neuropsychological testing or by another clinical professional
- evidence of ‘causative mutation’ from family or genetic testing

Question 12

what are the multiple etiologies/several causes of nuerocognitive disorders/dementia

Answer 12

• alzheimers
• vascular
• lewy body
• prion disease
• fronto-temporal
• parkinsons
• huntingtons
• HIV
• TBI
• substance/medication induced

Question 13

what is alzheimers, who first described it, and when

Answer 13

described by German neurologist Alois Alzheiemr in 1906
- progressive loss of brain tissue
- a leading cause of death in those over age 65 in US

Question 14

what is agnosia

Answer 14

inability to interpret sensations and hence to recognize things

Question 15

what is apraxia

Answer 15

difficulut preforming skilled movements (like walking)

Question 16

what is aphasia

Answer 16

loss of speech and communication skills

Question 17

what/who is a knowledgeable informant

Answer 17

a family member/friend/caretaker who is worried about the patient and/or able to provide information about their cognitive decline

Question 18

how are neurocognitive disorders diagnosed in a doctors office

Answer 18

family histoyr, rule out other disoders that could be causing symptoms, brief exam of cognitive function

Question 19

what are the genetics for familial alzheimers (4 different chromosomes)

Answer 19

Chromosome 21:
- formation of beta-amdyloid precursor protein
- single amino acid substitution
- 50 different mutations
Chromosome 1 and 14:
- 75% of early onset cases- presenilin 1 and 2; affects breakdown of amyloid
- (presenilin: part of gamma-secretase; a transmembrane enzyme that processes/cuts proteins into soluble products)
Chromosome 19 (ApoE-4 allele)
- overproduction of beta-amyloid

Question 20

brain pathology involves what + what

Question 21

what are tau protiens

Question 22

what are neurofibrillary tangles and beta-amyloid plaques? where are they found? what is beta and gamma secretase

Question 23

what are detrimental and protective factors

Question 24

what are some acetylcholinesterase inhibitors

Answer 24

treatment of alzheimers
- cognex (tacrine)
- aricept (donepezil)
- reminyl, razadyne (galantamine)
- excelon (rivastigmine)

Question 25

what are some glutamate reulators

Answer 25

alzheimers treatment
- namenda (mentamine)

Question 26

what are some antidepressants

Answer 26

also used in treatment of alzheimers; SSRIs, etc.

Question 27

what are some anti-infalmmatories (how long before symptoms do you have to be on these)

Question 28

what are other treatments such as lifestyle changes involving care and oversight for neurocognitive disorders

Answer 28

using external memory aids and providing engaging in pleasant activities and exercise

Question 29

what is vascular dementia and how is its progression different from alzheimers?

Answer 29

vasucalr dementia is caused by impaired blood flow to the brain (stroke, blood clot, etc.)
alzheimers worsens with time where as the symptoms caused by vascular dementia stay the same