Cognitive Disorders

Question 1

95% of Alzheimer’s cases present after this age

Answer 1

65

Question 2

Does early or late onset Alzheimer’s have a more rapid progression with more pronounced structural loss?

Answer 2

Early onset

Question 3

Alzheimer’s involves an accumulation of these two proteins, and is associated with progressive brain atrophy

Answer 3

Beta-amyloid plaques and Tau protein

Question 4

Gene mutation of amyloid precursor protein is associated with early onset Alzheimer’s, and is found on this chromosome

Answer 4

21

Question 5

Gene mutation of presenilin 1 is associated with early onset Alzheimer’s, and is found on this chromosome

Answer 5

14

Question 6

Gene mutation of apolipoprotein E gene is associated with late onset Alzheimer’s, and is found on this chromosome

Answer 6

19

Question 7

Mutation in this gene is associated with early onset Alzheimer’s, and is found on chromosome 21

Answer 7

Amyloid precursor protein

Question 8

Mutation in this gene is associated with early onset Alzheimer’s, and is found on chromosome 14

Answer 8

Presenilin 1

Question 9

Mutation in this gene is associated with late onset Alzheimer’s, and is found on chromosome 19

Answer 9

Apolipoprotein E

Question 10

The signature lesions of this condition are neuritic plaques and neurofibrillary tangles in cortical and medial temporal lobes of the brain

Answer 10

Alzheimer’s

Question 11

Neuritic plaques consist of this protein

Answer 11

Beta amyloid protein

Question 12

Neuritic plaques consist of beta amyloid protein, and are formed by processing of this

Answer 12

Amyloid precursor proteins

Question 13

Neurofibrillary tangles are common in these two locations of the brain in Alzheimer’s patients

Answer 13

Hippocampus and Cerebral cortex

Question 14

Neurofibrillary tangles are composed of this

Answer 14

Abnormally hyperphosphorylated tau proteins
(support the neuron’s microtubule system)

Question 15

Are neurofibrillary tangles composed of hypo- or hyperphosphorylated tau proteins?

Answer 15

Hyperphosphorylated

Question 16

Abnormally hyperphosphorylated tau proteins form this lesion that is characteristic in Alzheimer’s disease

Answer 16

Neurofibrillary tangles

Question 17

This part of the brain is especially noted to shrink in Alzheimer’s disease

Answer 17

Hippocampus

Question 18

In Alzheimer’s disease, deposition of this may parallel local inflammatory/immunologic alternations

Answer 18

Amyloid

Question 19

Loss of this activity in hippocampus and cortex correlates with Alzheimer’s disease severity

Answer 19

Cholinergic activity

Question 20

This condition is a progressive memory impairment with some sparing of procedural (motor) memory

Answer 20

Alzheimer’s disease

Question 21

Is procedural (motor) memory spared in Alzheimer’s disease?

Answer 21

Some yes
(may have aphasia, apraxia, agnosia, executive dysfunction)

Question 22

This is a highly sensitive test that can assess the severity of Alzheimer’s disease

Answer 22

Montreal cognitive assessment (MOCA)

Question 23

MRI or CT of a patient with Alzheimer’s disease will show a decrease in this

Answer 23

Grey matter volume

Question 24

In Alzheimer’s disease, is grey or white matter volume decreased?

Answer 24

Grey

Question 25

When imaging Alzheimer's disease, amyloid plaque deposition will be seen in this type of scan

Answer 25

PET

Question 26

Does this describe dementia, pseudodementia, or normal aging: Severe memory loss with decrease in IQ

Answer 26

Dementia

Question 27

Does this describe dementia, pseudodementia, or normal aging: Moderate memory loss with no change in IQ

Answer 27

Pseudodementia (depression that mimics dementia)

Question 28

Does this describe dementia, pseudodementia, or normal aging: Minor forgetfulness with no change in IQ and no disruption of normal life

Answer 28

Normal aging

Question 29

This measure is decreased in dementia but not pseudodementia or normal aging

Answer 29

IQ

Question 30

Centrally acting inhibitors of this enzyme may be used to treat Alzheimer's disease

Answer 30

Cholinesterase (Increase and prolong acetylcholine concentrations at the synapse)

Question 31

This is an NMDA receptor antagonist that may be used to treat Alzheimer's disease

Answer 31

Memantine

Question 32

Donepezil is a centrally acting inhibitor of this enzyme, and can be used to treat Alzheimer's disease

Answer 32

Cholinesterase

Question 33

Rivastigmine is a centrally acting inhibitor of this enzyme, and can be used to treat Alzheimer's disease

Answer 33

Cholinesterase

Question 34

This is the preferred formulation of centrally acting cholinesterase inhibitors in Alzheimer's disease

Answer 34

Rivastigmine Patch

Question 35

The presumed MOA of this drug in Alzheimer's disease is reduction in glutamatergic overstimulation at the NMDA receptor

Answer 35

Memantine

Question 36

What is the MOA of Memantine in Alzheimer's disease?

Answer 36

Reduction in glutamatergic overstimulation at the NMDA receptor

Question 37

These receptors in CNS appear critical for memory formation, but overstimulation is damaging

Answer 37

Glutamate

Question 38

This type of drug for Alzheimer's disease has a black box warning of increased risk of death by cardiovascular or infectious diseases in elderly demented patients (risk highest in patients with Lewy body dementia)

Answer 38

Antipsychotics

Question 39

Antipsychotics have a black box warning of increased risk of death from these diseases in elderly demented patients

Answer 39

Cardiovascular / infectious diseases

Question 40

Type of dementia characterized by impaired attention, early language changes, and memory can be intact

Answer 40

Fronto-temporal dementia

Question 41

Type of dementia that is more likely to have concurrent motor deficits

Answer 41

Vascular dementia

Question 42

Vascular dementia is more likely to have concurrent deficits of this type

Answer 42

Motor

Question 43

Dementia that must have attention and executive function deficits, and delayed memory impairment

Answer 43

Dementia with Lewy Bodies

Question 44

In Dementia with lewy bodies, this impairment must be delayed

Answer 44

Memory

Question 45

Patients with this type of dementia may have fluctuating cognition, recurrent visual hallucinations, REM sleep disruptions early in disease, and spontaneous features of parkinsonism

Answer 45

Dementia with lewy bodies

Question 46

Type of dementia with gradual progressive decline of general memory

Answer 46

Alzheimer's disease

Question 47

Type of dementia that may be acute with recovery sometimes

Answer 47

Vascular

Question 48

Type of dementia that may have visual hallucinations

Answer 48

Lewy body

Question 49

Parkinson's develops about a year into disease with this type of dementia

Answer 49

Lewy body

Question 50

This condition develops about a year into disease with Dementia with lewy bodies

Answer 50

Parkinson's

Question 51

Type of dementia characterized by deficits in attention, language changes, early and odd behaviors often noted

Answer 51

Frontotemporal

Question 52

Is delirium acute or delayed onset?

Answer 52

Acute and sudden

Question 53

This condition is a disturbance in attention and awareness that develops over a short period of time and tends to fluctuate

Answer 53

Delirium

Question 54

What are the two requirements of a delirium diagnosis?

Answer 54

Acute onset and fluctuating course Inattention

Question 55

Is there reduced consciousness in delirium?

Answer 55

Yes

Question 56

Is there reduced consciousness in dementia?

Answer 56

No

Question 57

Is delirium short or long duration?

Answer 57

Brief

Question 58

Is there disorganized speech in delirium?

Answer 58

Yes

Question 59

Is there disorganized speech in dementia?

Answer 59

Mostly no (aphasia or anomia in severe states)

Question 60

Haloperidol is first-line therapy for this

Answer 60

Hyperactive delirium

Question 61

This drug is the first-line therapy for hyperactive delirium

Answer 61

Haloperidol

Question 62

This drug should be avoided in delirium due to its ability to worsen confusion, increase risk of falls, and disinhibited behaviors

Answer 62

Benzodiazepines

Question 63

What drug should be avoided in the treatment of delirium?

Answer 63

Benzodiazepines

Question 64

Risperidone, Quetiapine, Haloperidol, and Olanzapine are commonly used medications to treat this condition

Answer 64

Delirium

Question 65

This benzodiazepine is preferable to other benzos in treating benzodiazepine, barbiturate or alcohol withdrawal delirium

Answer 65

Lorazepam