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geriatrics > Trigger - Dementia, D, D > Flashcards

Trigger - Dementia, D, D Flashcards

1
Q

what causes increased risk of hemorrhage before sx show

A

thickened leptomeninges in the spinal cord

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2
Q

seizures, dementia and aphasia

A

sx of cerebral atrophy

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3
Q
  1. look for reversible causes
  2. identify/modify vascular RF
  3. cog training, exercise
A

mild cog impairment

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4
Q

cerebral atrophy beginning in the hippocampus and entorhinal cortex. causes widespread shrinking of brain tissue

A

alzheimers etiology

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5
Q

what is associated with amyloid plaques and neurofibrillary tangles

A

alzheimers disease

unknown if these cause disease or if these are a result of disease

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6
Q

tau proteins adhering to each other instead of to the microtubules. results in inadequate transfer of info from cell body to axon terminal.

A

Neurofibrillary tangles

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7
Q

MC in females

A

alzheimers

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8
Q

assocaited with Apo ε4 gene on chromosome 19 as well as trisomy 21

A

alzheimers

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9
Q

difficulty learning & recalling info
visuospatial problems
language mpairment

A

classic triad of alzheimers

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10
Q

depression, apathy and irritability

A

early behavioral changes in alzheimer’s

late are: agitation and psychotic s/s such as delusions, hallucinations, paranoia

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11
Q

agitation and psychotic s/s such as delusions, hallucinations, paranoia

A

late behavioral changes in alzheimer’s

early are: depression, apathy, irritability

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12
Q

mild/mod/severe AD?

trouble recalling new names and taking longer time to perform daily tasks

A

mild.
also see:
longer time to perform daily tasks
recognizing familiar places
paying bills, handling money
recalling new names
word recall
losing or misplasing items
pallning or organizing
remember new reading material

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13
Q

mild/mod/severe AD?

easily lost, difficulty recognizing friends/family, loss of new learning

A

Mod
also see:
recalling demographics
easily lost
disorientated to place/time
short attention span
disorganized thought processes
choosing appropriate clothing
difficulty recognizing family/friends
repetitive statements
loss of new learning
behavioral changes
psychotic sx
trouble reading, writing

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14
Q

mild/mod/severe AD?

weight loss, increased sleep, trouble swallowing

A

severe
also see:
absent recognition of family/friend
wt loss
increased sleep
loss of bowel/bladder control
Death often occurs due to a complicating illness (aspiration pneumonia)
increased infections
trouble swallowing
unable to communicate effectively

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15
Q

aspiration pneumonia

A

MC infection in AD

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16
Q

CT/MRI shows diffuse cortical or cerebral atrophy with a greater degree in the hippocampal area

A

Alzheimers

remember imaging is NOT DIAGNOSTIC for AD. Alzheimers is usually diagnosed clinically when there is evidence of cog dysfunction that leads to functional impaitment after r/o other causes of dementia

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17
Q

what are the cholinesterase inhibitors

A

donepezil
glantamine
rivastigmine

aricept
razadyne
exelon

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18
Q

what are the NMDA receptor antagonists

A

memantine
namzaric ( COMBO DRUG NMDA/cholinesterase inhib)

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19
Q

increases acetylcholine at synapse

A

cholinesterase inhibitors

donepezil
glantamine
rivastigmine

aricept
razadyne
exelon

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20
Q

SE include N/D and sleep disturbance. TAKE W FOOD

A

cholinesterase inhibitors

also: severe - bradycardia, AV block, syncope

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21
Q

SE: bradycardia, AV block, syncope. start low go slow, titrate up q 2 months

A

cholinesterase inhibitors

also see: N/D, anorexia, sleep disturbance
take w food!

22
Q

inhibits B amyloid production

A

NMDA receptor antagonists

memantine

23
Q

SE is dizziness, HA, confusion, constipation

A

NMDA receptor antagonist

24
Q

when should you DC cholinesterase inhibitors and NMDA receptor antagonists in an AD pt

A

once pt is unable to express their needs.

25
Q

Difficulty of timed activities and executive functions - One-minute semantic test

A

vascular dementia

26
Q

less memory impairment than AD but MORE depression

A

vascular dementia

27
Q

MRI shows small infarcts (white matter lesions)

A

vascular dementia

28
Q

risks include HTN, smoking, DM, statins, antiplatelets

A

vascular dementia

29
Q

deposits of alpha-synuclein

A

lewy bodies

30
Q

MC in males

A

DLB

31
Q

insidious onset of fluctuating cog impairment day to day presenting with delusional misidentification often as 1st symptom

A

DLB

32
Q

REM sleep disorder, visual hallucinations, bradykinesia, limb rigidity and flat affecrt

A

DLB

also HALLMARK = parkinsonism

33
Q

also HALLMARK = parkinsonism

A

DLB

34
Q

SE includes parkinsonism and neuroleptic malignant syndrome

A

antipsychotics

35
Q

MRI shows atrophy of basal ganglia structures and dorsal midbrain

A

DLB

36
Q

SPECT shows decreased dopamine uptake and perfusion

A

DLB

37
Q

MRI shows cortical atrophy with substantia nigra changes

A

parkinsons disease

38
Q

fever, AMS, autonomic dysfunction

A

neuroleptic malignant syndorme

SE of antipsychotics. LIFE THREATENING RXN

39
Q

MRI shows focal atrophy of frontal, insular and/or temporal cortex

A

frontotemporal dementia

40
Q

which FTD variant shows Medial and orbital frontal and anterior insula degeneration

A

Behavioral variant FTD

41
Q

which FTD variant shows Anterior temporal degeneration

A

Semantic variant Primary Progressive Aphasia (PPA)

42
Q

which FTD variant shows Dominant hemisphere lateral frontal and precentral gyrus atrophy

A

Non-fluent/agrammatic Primary Progressive Aphasia

43
Q

Changes in personality, Apathy, disinhibition, compulsivity, loss of empathy, and overeating

A

Behavioral variant (bvFTD) - MC

44
Q

Loss of ability to decode/recalling words, object, person-specific

A

Semantic primary progressive aphasia variant FTD

45
Q
  • Inability to produce words, often with prominent motor speech impairment
  • Broca’s area
A

Primary progressive aphasia (non-fluent/agrammatic variant)

46
Q

non pharm is first line

if pharm failts use SSRI or trazodone

A

FTD

47
Q

abnormal gait, UI, and dementia

A

normal pressure hydrocephalus

48
Q

management = ventricular shunting

A

normal pressure hydrocephalus

49
Q

diagnosed w MRI showing ventriculomegaly in ABSENCE of sulcal enlargment

A

normal pressure hydrocephalus

can also dx w high volume LP

50
Q

identify/tx underlying cuase
eradicate contributing factors
manage s/s

A

delerium tx

51
Q

i didnt include meds pros and cons so go look

A

k will do

geriatrics (12 decks)

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