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Flashcards in Confusion in the elderly Deck (25):
1

True or false: cognitive decline is probably the most common area that a geriatrician will be consulted about?

True

2

What are the two types of confusion?

Acute and chronic

3

What is dementia?

A syndrome characterized by an impairment in two or more intellectual or cognitive functions despite a state of clear consciouness

4

How do you distinguish between dementia from delirium?

Dementia is persistent and stable

5

True or false: any acute change in mental status is delirium until proven otherwise

True

6

What is the first step in evaluating cognitive decline?

Comprehensive H&P

7

What is the Folstein mini mental exam?

**Rough** test of mental ability

8

What are the lab tests that are not obvious to get to evaluate for dementia? (3)

VDRL
B12
Homocysteine levels

9

What is the DEMENTIAS mnemonic?

Drugs
Emotional disease
Metabolic disorders
Endocrine disease
Nutrition & degenerative neurologic disease
Trauma/tumor
Ischemia and infection
Anorexia/anemia/arrhythmia
Sjogren's, social, sensory deprivation

10

What are the four daignoses that account for most cases of dementia in industrialized countries?

1. Alzheimers
2. Diffuse lewy body disease
3. Vascular dementia
4. Frontotemporal dementia

11

What is agnoisa?

Difficulty recognizing things

12

What is apraxia?

Inability to carry out motor functions

13

What is aphasia?

Difficulty naming familiar items

14

What is amnesia?

Initially short term memory

15

What are the pathological hallmarks of alzheimer's?

Fibrillary tangles

16

What is Lewy body dementia?

Intraneuronal inclusions that contain alpha-synuclein, phosphorylated neurofilament proteins, and ubiquitin

17

What are the two neurotransmitters that we attempt to upregulate?

Ach
Glutamate

18

What are the four clinical features of Lewy body dementia?

1. Dementia
2. Fluctuating cognition
3. Recurrent visual hallucinations
4. Motor features of parkinsons

19

Fluctuating cognition is characteristic of what disease?

Lewy body dementia

20

What is the treatment of Lewy body dementia?

Ach esterase inhibitors

21

What is vascular dementia?

Caused by decreased blood flow to the brain with significant enough brain damage to cause cognitive impariment

22

What is the presentation of vascular dementia?

Stepwise deterioration

23

What are frontotemporal disorders?

A heterogenous group of disorders that are less common than AD, DLBD, and vascular demnentia

24

What are the findings of Pick's disease, the most common frontotemporal disorder?

Focal atrophy of the frontal and temporal lobes, along with microscopic findings of argyrophilic inclusions and swollen, achromatic neurons

25

Disinhibition in dementia = ?

Pick's disease