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Neurology > Dementia > Flashcards

Dementia Flashcards

1
Q

dementia

A

impair 2/5 functional domains: memory, emotion, executive, language, visuospatial- impacts ADL

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2
Q

mild cognitive impairment

A

doesn’t meet criteria for dementia bc no impairment in function. RF for alzheimer’s bc 15% dev dementia annually

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3
Q

types of memory

A

episodic- persoanl experiences, primary affected in AD. semantic memory- facts. declarative memory- semantic + episodic memory.. procedural - how do do things= less affected

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4
Q

AD v brain areas

A

atrophy of medial temporal lobe (hippocampi). preserve primary motor and visual cortices. over time –> diffuse brain atrophy.

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5
Q

pittsburg compound B

A

used in PET scans to image beta amyloid plaques in the brain and is used in research for AD

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6
Q

cholinesterase inhibitors

A

used to improve functional and psychiatric sx in early stages of alzheimers. but don’t delay natural history of alzheimer. works bc acetylcholine is made in nucleus baseless of meynert. ex donepezil

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7
Q

memantine (damenda)

A

improve AD pt’s functional ability. dear glutaminergic overstimulation by inhibiting NMDA R.

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8
Q

familial AD

A

mut amylod precursor. age of onset of AD decr as #apolipoprotein E e4 alleles incr

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9
Q

AD patho

A

cortical neuritic plaques and neuronal loss in cerebral cortex. -these are seen in elderly pt without clinical dementia too.

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10
Q

down syndrome

A

neurodev model for alzhmeimers inevitable

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11
Q

AD

A

age is most important RF. W>M. high edu is protective, most common demential in pt >65. dx can’t be made solely on MRI findings.

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12
Q

delirium v AD

A

there are fluctuations of arousal in delirium

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13
Q

evaluate pt with dementia

A

goal: find reversible cause- in minority of pt.
1) electrolyte panel, renal func, hepatic func, TSH, serologic test for syphilis, B12, UA, tox screen, HIV test
2) neuroimaging
3) complete list of medication looking specifically for anticholinergic med, benzodiazepine, opiates
5) LP and EEG only when there are red flags - early onset or rapidly progressing dementia, IC pt, focal neurological findings, sign of systemic illness
6) demential v delirium

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14
Q

diffuse lewy body disease (DLBD)

A

Main: cog decline. fluctuating condition with variation in attention and alertness. prominent visual hallucinations, may have sx of parkinsonism, motor sx (bradykinesia and gain abn). pt are hypersensitive to antipsychotics. sleep disturbance and orthostatic hypotension. def of executive fun

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15
Q

lewy body

A

composed of alpha synuclein. seen in many neuro D like parkinson

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16
Q

parkinson v DLBD

A

both have parkinsonism, motor sx, gait abn, deficits of executive fun. fluctuating cognition and attention/alertness supports DLBD

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17
Q

charles bonnet syndrome

A

mentally healthy with sig visual loss. visual hallucination- animal ppl. know they aren’t real.

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18
Q

frontaltemporal lobe degeneration

A

aka pick’s disease. 1) behavioral disinhibition/poor judgment( conduct prob, antisocial, substance use, novelty seeking, impulsitivity, HIV related risk behavior) can get 2) apathy, abulia. 3) language disturbance- dv global language difficulties- primary progressive aphasia.
unusual features include: dev new artistic skills. norm memory and general intelligence, basic labs, to screen
occur at younger age and more rapid than other demential. memory is often unaffected

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19
Q

ropinirole (requip)

A

dopamine agonist for parkinson disease. one SE is incr impulsivity like gambling or hyper sexual behavior

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20
Q

wenicke-korsakoff syndrome. patho,

A

necrosis of maxillary bodies. due to def of thiamine/vit B1. giving glu bc thiamine trigger change in Mental status

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21
Q

wenicke-korsakoff syndrome sx

A

1) ataxia- mainly gait
2) encephalopathy
3) eye movement abn including nystagmus and ophthalmoparesis
amnesia and confabulation= unintentional creation of false memories or beliefs. rapid clinical onset.

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22
Q

korsakoff pt types

A

1) chronic alcoholic + IV glucose in ER
2) ICU pt
3) post gastric bypass pt

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23
Q

ganser’s syndrome

A

= prison psychosis- syndrome of approximate answers. in prison inmates to manipulate legal situation. form of malingering

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24
Q

vascular dementia

A

present in step wise fashion. focal neuro deficit. RF- stroke (age, HTN, DM, smoking, lipids). can present after stragitacally placed lesion to hippocampus, medial thalamus, or caudate nucleus. often occur in conjunction with other dementing processes like alzheimers

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25
Q

normal pressure hydrocephalus

A

triad: magnetic gait, dementia, urinary urgency/ freq (wobbly, weird, wet) gait is apraxia and pt can mimic walking while lying or sitting. tx. ventriculoperitoneal shunt (at risk for dev subdural hematoma due to dear ICP that pulls brain away from meninges –> tears veins). dx: continuous lumbar drain.
cause: previous pathology in subarachnoid space (meningitis, subarachnoid blood) that interfere with reabsorption of CSF in arachnoid granulation

26
Q

shunt surgery pt need

A

1 of 4. 1) clearly identified etiology of hydrocephalus 2) gait difficulties >cog impairment 3) substantial improvement after CSF removal 4) no atrophy and WM lesions on imaging

27
Q

transient global amnesia

A

complete and reversible anterograde and retrograde memory loss lasting up to 24hr. often occur in emotional or sexual activity. migraine phenomenon. rarely recurs though pt need to be worked up for vascular disease and epilepsy. tx with observation bc self limited disorder.
MRI show temporary abn in hippocampus

28
Q

limbic encephalitis

A

MRI: bilateral hyperintesity of mdial temporal lobe and frontal lobes. CSF show anti-Hu ab.

29
Q

paraneoplastic limbic encephalitis

A

most commonly associated with small cell lung carcinoma. in young otherwise health girls, more likely associated with ovarian tumor

30
Q

kluver-bucy syndrome

A

hypersexuality, plaicidity - decr fear response. docile in settings that should trigger fear, aggressiveness, anger. hyperphagia and hyperorality-overeat + examine obj with mouth, pica. visual agnosia- can’t rec familiar faces or obj

31
Q

wenicke’s aphasia

A

receptive, sensory, fluent aphasia. can’t understand language. correct grammar but nonsensical. can’t repeat phrases or follow complex commands. not aware of deficit. not associated with weakness

32
Q

transcortical sensory aphasia

A

lesion in arcuate fasiculus. mild word finding problem, sig trouble naming obj, can’t repeat phrases, can follow simple commands

33
Q

abnormal prosody

A

lesion in right inferior frontal gyrus. improper intonation.

34
Q

pure word deafness

A

bilateral lesion in primary auditory cortex in the superior temporal lobe or disruption of connection between these areas. can’t comprehend speech meaning, but can hear sounds, speak, read, write

35
Q

akinetic mutism

A

lesion in cingulate gyrus bilaterally - only speak in extreme duress

36
Q

cingulate gyrus

A

involve in emotions and reg aggressive behavior. abn found in schizophrenia and OCD

37
Q

MCA v aphasia

A

supply bloc’s and wernicke’s

38
Q

dysphonia

A

due to problem of vocal cord- sound hoarse or breathy

39
Q

dysarthria

A

speech problem due to bad M of articulation

40
Q

aphasia

A

language problem from brain injury

41
Q

broca’s

A

expressive, non-fluent aphasia. can’t produce language or repeat phrases, intact comprehension, aware of deficit. associate with weakness. when recovery can become a transcortical motor aphasia

42
Q

transcortical motor aphasia

A

as per broca with intact repetition

43
Q

transcortical sensory aphasea

A

as per wernicke’s with intact repetition

44
Q

global aphasia

A

broc + wernicke. mute. sig weakness

45
Q

mixed transcortical aphasia

A

~ global with intact repetition

46
Q

anomic aphasia

A

can’t name obj

47
Q

neologism

A

make up words

48
Q

phonemic paraphrasia/ literal paraphrasia

A

mispronuciation, syllables out of seq.

49
Q

semantic paraphrasia

A

substituted word is related to intended word.

50
Q

gerstmann’s syndrome

A

lesion to dominant angular gyrus-area of parietal lobe near superior edge of temporal lobe. agraphia-def in writing. acalculia- def in learning or comprehending math. finger agnosia- can’t distinguish fingers on hand. left-right confusion

51
Q

apraxia

A

disorder of skilled mvt not caused by weakness, akinesia, deafferentation, ab tone or posture, mvt disorders like tremor or chorea, intellectual deterioration, poor comprehension or uncooperativeness

52
Q

right parietal lobe

A

neglect. don’t realize there is a problem with CL side of body

53
Q

prosopanosia

A

fusiform gyrus of temporal lobe. lose facial recognition

54
Q

astereoagnosia

A

parietal lobe/primary somatosensory cortex lesion. can’t rec obj by touch

55
Q

alexia without agraphia

A

lesion in left occipital lobe ++ splenium. could be caused by infarction of PCA. visual info only reach only the right occipital lobe but can’t be processed by language areas on left. so can’t read but can write.

56
Q

anton’s syndrome

A

denial of blindness due to damage in bilateral occipital lobes.

57
Q

balint’s syndrome

A

damage to both posterior parietal lobes.

1) optic ataxia- incoordination of hand and eye mvt
2) oculomotor apraxia- no voluntarily guide eye mvt
3) simultanagnosia- inaility to perceive more than 1 obj at a time in one’s visual field

58
Q

kleine-levin syndrome

A

sleep a lot. awake-spacey, childlike. at times, hungry and hypersexual

59
Q

pseudobulbar palsy

A

emotional outburst without matching feelings. tx by dextromethorphan/quinidine. seen in MS, ALS, AD

60
Q

alien hand syndrome

A

associated with demential, it occur in corticobasal dengeneration. cones of epilepsy surgery where corpus callosum is severed to prevent generalization of seizures.

Neurology (18 decks)

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