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Year 2 neuro exam 2 > Dementia, Cohen I > Flashcards

Dementia, Cohen I Flashcards

1
Q

cognition

A

mental process of knowing, including aspects like awareness, perception, reasoning and judgement

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2
Q

dementia defintion

A

deterioration cognition, higher intellectual process, organic disease of brain

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3
Q

DSM IV

A

development of multiple cognitive deficits that are sufficiently severe to cause impairment in occupational or social functioning

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4
Q

is dementia reversible

A

irreversible

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5
Q

common initial presentation of dementia

A

delirium

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6
Q

primary causes of dementia

A
  • —alzheimers
  • -lewy body dementia/Parkinsons
  • -multi infarct/Vascular dementia
  • -fronto-temporal demential
  • -alcoholism/VitB12 deficiency
  • subdural hematomas, creutzfeldt jacob, HIV, normal P hydrocephalus, tumors, progressive supranuclear palsy, huntington, MS, CTE
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7
Q

findings micro in alzheiemrs

A

plaques of amyloid

tangles of tau- containing microtubules inside neurons

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8
Q

what amyloid collects in alzheimers

A

beta amyloid

AB42 from amyloid precursor protein

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9
Q

where is most cell death in alzheimers

A

temporal and parietal lobes

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10
Q

major connection to alzheimers

A

downs by age 50 60s

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11
Q

what NT is lost in alzheimers

A

Ach

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12
Q

what collection amyloid or tau is thought to have role in dementia

A

tau

amyloid blockers or lowering agents not helpful in alzheimers

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13
Q

prevalence of Alzheimers

A

> 80 majority
65 common
M

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14
Q

associations with development of alzheimers

A

mentally inactive people
victims head trauma
homozygous e4 allele ApoE

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15
Q

begining of alzheimers

A

loss of memory for recent information or events like appointments
objects misplaced
trouble recalling names of DISTANT friends at first
repeating stories
restricted speech, cannot complete sentence

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16
Q

progression alzheimers

A 
visuospatial decline (wandering)
gait disorder with dizziness and poor posture (extension)
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17
Q

mental state alzheimers

A 
boredom, lack of social inhibitions
irritability
paranoia
denial relationships
depression
can become violent or anxious and agitated
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18
Q

what is “sundowning”

A

confusion and agitation at night

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19
Q

apraxia

A

loss of simple actions because loss of connections between cortical sites
(inability to button clothing or brush hair etc)

20
Q

Mild alzheimers

A

safe at home
some help with acticities
not threat to self

21
Q

moderate alzheimers

A

kept at home with great effort

full or nearly full caregiver

22
Q

severe alzheimers

A

nursing home or assisted liviing for round-the-clock supervision

23
Q

Dx of alzheimers

A

clinical

24
Q

What is PiB

A

pittsburgh compound that binds to beta amyloid deposition in brain

25
Q

amyloid levels and tau levels in CSF in alzheimers

A

dec beta amyloid
increase tau
(soluble)

26
Q

MRI of alzheimers

A

atrophy in medial temporal lobes

27
Q

Must rule out for Dx alzheimers

A

B12
thyroid
renal and hepatic problems

28
Q

thought behind ACHE inhibitors in alzheimers

A

increase Ach for relief memory impairment, agitated behavior and concentration

29
Q

effect of ACHEI in alzheimers patients

A

modest gains with slower decline

no major difference than non-Tx patients in 2-3 years

30
Q

ACHEI used in alzheimers

A

donepezil
rivastigmine
galantamine

31
Q

most widely used ACHEI in alzheimers

A

donepezil

32
Q

effects of rivastigmine

A

vomtiing, diarrhea

also have as skin pathc to lower effects

33
Q

which ACHEI in alzheimers has extended release

A

galantamine

34
Q

MOA memantine

A

antagonizes glutamate and NMDA R
may prevent cell death from too much glutamate
used alone or with ACHEI

35
Q

Good Tx for alzheimers

A

keep patient mentally and physically active

prevent from seeking social isolation

36
Q

“mild cognitive impairment”

A

patients who function well in social and occupation
very limited problems with memory
do not meet requirements for alzheimers

37
Q

Second common cause dementia

A

lewy body dementia

38
Q

presentation lewy body dementia

A 
agitated
decreased facial animation
slowness and imbalance
mild to no tremor
dementia
M>W
39
Q

dementia in lewy body

A

Fluctuating!!!!

40
Q

key signs to lewy body to distinguish from alzheimers

A

visual hallucinations!!
parkinosism
bad response to antipsychotic drugs

41
Q

lewy body patients may improve with what therapy

A

ACHEI

42
Q

what is aggregate in lewy body

A

alpha synuclein

also senile plaques and neurofibrillary tangles

43
Q

lewy body involves what parts of brain

A

diffuse

ANS severely effected

44
Q

worse prognosis alzheimers or lewy body

A

lewy body

death 5-7 yearas

45
Q

what drugs make agitation in lewy body disease worse

A

antipsychotics
olanzapine
risperidal
haloperidol

46
Q

lewy body incorrectly Dx as

A

parkinsons

47
Q

Tx parkinsonism Sx in lewy body disease

A

low doses levadopa

Year 2 neuro exam 2 (23 decks)

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