Neurogenerative Disorders Flashcards
What is the diagnostic criteria for dementia?
Acquired, persistent and progressive impairment of intellectual function with compromise of memory and at least 1 other cognitive domain
What are examples of cognitive domain required to dx a pt with dementia?
- Aphasia
- Apraxia
- Agnosia
- Impaired executive function
Is dementia rapid or insidious onset and is it progressive or no?
Insidious and progressive deterioration
Does dementia cause impairment in autonomic arousal and impairment in mentation?
- No impairment in autonomic arousal
- Consistently impaired mentation
Is alertness retained or lost in dementia and is agitation present?
- Alertness is retained in early stages
- Agitation is less prominent
Does dementia vary with stress? and if pt is psychotic what usually occurs in a pt with dementia?
- Varies with stress
- If psychotic, usually vague paranoid ideas in middle stages
What is a common concomitant of early dementia?
Depression
What is dementia w/ lewy bodies?
Cognitive dysfunction w/ prominent visuospatial and executive deficits
What are some sxs of dementia w/ lewy bodies?
- Psychiatric disturbance
- Anxiety
- Visual hallucinations
- Fluctuating delirium
- Parkinsonian motor deficits w/ or after other features
What medication lessens delirium in a pt with dementia w/ lewy body?
Cholinesterase inhibitors
Is delirium a rapid or progressive onset? And what is the duration?
Rapid onset and short duration
Is autonomic arousal and consciousness affected in a pt with delirium? If so, how?
- Heightened autonomic arousal
- Clouded consciousness
What are some sxs of delirium?
- Gross confusion
- Restless
- Agitated
- Hypervigilant
- Lethargic
Does delirium cause visual disturbance? If so, what?
- Gross perceptual disruptions
- Hallucinations
What are some causes of delirium?
- Central nervous system disorder
- Metabolic disorder
- Systemic illness
- Medications
- OTC preparations
- Botanicals
- Cardiac
- Pulmonary
- Endocrine
- Renal
- Hepatic
- Neoplasm
- Drugs of abuse
- Toxins
What are sxs of frontotemporal dementia?
- Personality and behavior changes
- Sudden lack of inhibitions in person and social situations
- Problems coming up with the right words
- Movement problems: shakiness, balance, muscle spasm
What is disease make up 30% of frontotemporal dementia?
Picks disease
What does picks disease affect?
It affects parts of the brain that control emotions, behavior, personality, and language
What causes frontotemporal dementia?
Familial cases result from mutations in genes for tau, progranulin, or others
What are some behavioral variants in behavioral variant frontotemporal dementia?
- Deficits in empathy, social comportment, insight, abstract though, and executive function
- Behavior is disinhibited, impulsive, and ritualistic
- Prominent apathy and increased interest in sex or sweet/fatty foods
What are the effects of behavioral variant frontotemporal dementia on memory?
Relative preservation of memory
Where is atrophy of the brain in a pt with behavioral variant frontotemporal dementia?
Focal right frontal atrophy
What is behavioral variant frontotemporal dementia associated with?
ALS
What are some sxs seen in semantic variant primary progressive aphasia frontotemporal dementia?
- Deficits in word-finding, single-word comprehension, object and category knowledge, and face recognition
- Similar behavior as Behavioral variant FTD
Where is atrophy of the brain in a pt with semantic variant primary progressive aphasia frontotemporal dementia?
Asymmetric temporal pole atrophy
What are some sxs seen in nonfluent/agrammatic variant primary progressive aphasia frontotemporal dementia?
- Speech is effortful w/ dysarthria, phonemic errors, sound distortions, and poor grammar
- Focal extrapyramidal signs and apraxia of the right arm and leg
- Overlaps with corticobasal degeneration
Where is atrophy of the brain in a pt with nonfluent/agrammatic variant primary progressive aphasia frontotemporal dementia
Focal left frontal atrophy
What is vascular dementia?
Stepwise or progressive accumulation of cognitive deficits in association with repeated strokes
What do sxs of vascular dementia depend on?
Sxs depend on localization of strokes
What is Alzheimers?
MC age-related neurodegenerative disease, not fatal
- incidence doubles every 5 years after age 60
How is memory affected by Alzheimers?
Short-term memory impairment is early and prominent
What are the deficits noted with Alzheimers?
Variable deficits of executive function, visuospatial function, and language
What is the cause of Alzheimers?
Plaques containing-beta amyloid peptide and neurofibrillary tangles containting tau protein
What is the more common in Alzheimers compared to vascular dementia?
- Visuospatial function
- Attention
What is the more common in vascular dementia compared to Alzheimers?
- Immediate memory
- Language
- Delayed memory
