Dementia, Cohen II

Question 1

multi infarct dementia

Answer 1

clincally Hx stokes and hemorrhagic strokes

Step like downhill course

Question 2

clinical findings multi infarct dementia

Answer 2

focal findings on exam: aphasia, dysarthria, hemiparesis, spasticity, visual field cuts

Question 3

seizures are more common in what type dementia

Answer 3

multi infarct

Question 4

likely concurrent comorbidities in multi infarct dementia

Answer 4

coronary artery disease
peripheral vascular disease
carotid stenosis

Question 5

What are risk factors for multi infarct dementia

Answer 5

HTN
DM
HLD
obesity, inactivity
smokers, alcohoics
known CAD, or Afib

Question 6

Tx of those at higher risk for multi infarct dementia

Answer 6

control risk factors
aspiring and other inhibitors of platelet aggregation
anti coagulants

Question 7

Fronto-temporal Lobar Dementia

Answer 7

family of multiple disorders with dementia

decline in behavior and speech!!

Question 8

autopsies and MRI of fronto-temporal lobar dementia

Answer 8

visible degeneration of frontal lobes and anterior temporal lobes!! MRI!!
increased tau!
TDP43!! and ubiquitin!!
M=W

Question 9

onset fronto temporal lobar degeneration

Answer 9

younger than AD
50s early 60s
“Picks”

Question 10

Dx frontotemporal dementia

Answer 10

MRI! frontal and anterior temporal lobe degeneration

Question 11

clinical features frontotemporal dementia

Answer 11

major personality changes like inappropariate actions, apathy, loss sexual inhibitions no concern appearance
shoplifting!
no ability to plan acitivites
become obsessed with certain subjects, clap hands inappropriately
over eat over drink

Question 12

frontotemporal dementia similar to what

Answer 12

ALS patients

Question 13

memory loss in frontotemporal dementia

Answer 13

later on

Question 14

Language form of frontotemporal dementia

Answer 14

progressive aphasia like Brocas
L hemisphere more atrophy than R
sentences shorter and shoter with progressive inability to name and read and write

Question 15

how to Dx frontotemporal dementia clinically

Answer 15

say things totally irrelevant
cannot name subject
gait ataxia
slow movements
poor decision making

Question 16

what tx help in frontotemporal dementia

Answer 16

antidepressants

sometimes antipsychotics

Question 17

What is Transmissible Spongiform Encephalopathy

Answer 17

CJD from prions

Question 18

what is prion

Answer 18

proteinaceous particles that can reporduce without nucelic acids

Question 19

progression CJD

Answer 19

rapid dementia over 1 year
prominent myclonic jerks
loss of balance and coordination, mildy extrapyramidal and sometimes cerebellar signs
occasionally familial

Question 20

Dx CJD

Answer 20

rapid downhill course
EEG triphasic waves
CSF: high levels 14-3-3 protein

Question 21

MRI CJD

Answer 21

rapidly accumulating subcortical deposits in cerebral hemispheres and cerebellar deposits sometimes

Question 22

brain Bx of CJD

Answer 22

prions and spongiform changes with loss of neurons and gliosis

Question 23

triad signs of normal pressure hydrocephalus

Answer 23

gait disturbance
incontinence
dementia
Wet Wide Weird

Question 24

1st sign normal P hydrocephalus

Answer 24

gait disturbance

wide based

Question 25

type of dementia in normal P hydrocephalus

Answer 25

decreased attention space
mental slowing
disorientation, confusion
depression

Question 26

MRI in normal P hydrocephalus

Answer 26

huge ventrilces

less prominent sulci

Question 27

Tx Norm P hydrocephalus

Answer 27

take off CSF like 20-30 cc