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BB Test 4 > Dementia > Flashcards

Dementia Flashcards

1
Q

Individuals with this sensory-related condition are frequently misdiagnosed as having dementia?

  1. Cataracts
  2. Sensorineural hearing loss
  3. Anosmia (loss of sense of smell)
  4. Loss of joint position sense
A
  1. Sensorineural hearing loss
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2
Q

______________ is the deterioration of cognition across multiple cognitive domains.

A

Dementia

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3
Q

Dementia usually consists of decline in two or more cognitive domains. What are the cognitive domains?

A
  • Memory
  • Executive function (planning, behavior modulation, etc.)
  • Complex attention
  • Language (both receptive and productive language)
  • Perceptual motor (learned motor tasks and mental mapping)
  • Social cognition
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4
Q

Dementias are often broadly categorized as _____________ or ____________.

A

Cortical or subcortical

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5
Q

What are the characteristics of cortical dementia?

A
  • Early aphasia and calculation difficulties
  • Minimal neurologic primary motor findings until very late
  • Usually effect higher-level structures first.
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6
Q

What are two examples of cortical dementias?

A
  • Alzheimer’s dementia
  • Frontotemporal dementia
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7
Q

Which lobe of the brain processes most forms of memory?

  1. Frontal
  2. Parietal
  3. Temporal
  4. Occipital
A
  1. Temporal
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8
Q

What lobe primarily deals with vision?

A

Occipital

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9
Q

What lobe primarily deals with memory function?

A

Temporal

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10
Q

What lobe primarily deals with personality and planning?

A

Frontal

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11
Q

What lobe primarily deals with spatial orientation, math, and calculation abilities?

A

Parietal

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12
Q

What lobes are effected in Alzheimer’s disease and what are the deficits that usually occur?

A
  • Lobe:
    • Temporal
    • Parietal lobes
  • Deficits:
    • Memory
    • Language,
    • Visuospatial ability
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13
Q

What are the abnormalities on the following MRI image? What disease does the patient most likely have?

A
  • Increased ventricular size is outlined in red.
  • Widening of sulci is outlined in blue.

These findings are common in Alzheimer’s disease patients.

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14
Q

What is the PET scan finding representative of Alzheimer’s dementia?

  1. Bilateral temporal lobe hypometabolism
  2. Bilateral frontal lobe hypometabolism
  3. One or two small areas of hypometabolism
  4. Unilateral parietal lobe hypometabolism
A
  1. Bilateral temporal lobe hypometabolism
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15
Q

The most common frontotemporal dementia is _______________.

A

Pick’s disease

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16
Q

How do patients with frontotemporal dementia usually presnet? What type of histological findings are seen upon autopsy?

A
  • Personality changes and disinhibition initially, as opposed to appearing later in the course of the disease which is common for the other dementia
  • These dementias typically show tau inclusions upon autopsy
17
Q

What type of dementias are characterized by deficits in the basal ganglia, causing early motor and speech difficulties?

A

Subcortical

18
Q

What are four examples of subcortical dementias?

A
  • Huntington’s disease
  • Wilson’s disease
  • Progressive Supranuclear Palsy
  • Limbic encephalopathy: Paraneoplastic
19
Q

What subcortical dementia is commonly associated with Parkinson’s disease?

A

Lewy Body dementia (about 25% of dementia cases)

20
Q

What lobes are commonly affected in Lewy Body dementia and what are the deficits seen?

A
  • Lobes:
    • Parietal
    • Temporal
    • Also subcortical brainstem lesions (protein aggregates the develop inside neurons)
  • Deficits:
    • Early losses in memory and language
    • Visual hallucinations (most commonly of little men or people)
    • Extrapyramidal symptoms
21
Q

_______________ is the second most common type of dementia and is often confused with Alzheimer’s.

A

Vascular dementia

22
Q

What are the characteristics of Vascular Dementia?

A
  • Rapid, stepwise declines in cognition and function
  • Often associated with focal neurologic deficits
  • Imaging findings often include old infarcts, lacunae, diffuse white matter changes, and subdural hematomas
23
Q

(T/F) Vascular dementia losses are irreversible, but treating vascular risk factors can slow progression.

A

True.

24
Q

Normal pressure hydrocephalus (NPH) may also be a cause of dementia. What is the classic triad of symptoms for NPH?

A
  • Dementia
  • Incontinence
  • Gait apraxia (magnetic gait)

NPH = DIG

25
Q

While documenting the history of a patient that you suspect of having dementia, what should you pay special attention to that may point to dementia?

A

The patient’s Instrumental Activities of Daily Living (IADLs).

  • Once they start to lose the ability to accomplish things such as bathing, dressing, paying the bills, grocery shopping, you may more strongly suspect a dementia.
26
Q

The primary goal in obtaining an MRI of the head in a dementia work-up is to:

  1. Confirm dementia by demonstrating cortical atrophy
  2. Confirm dementia by demonstrating enlarged ventricles
  3. Confirm dementia by demonstrating temporal hypometabolism
  4. Rule out a tumor or other mass lesion
A
  1. Rule out a tumor or other mass lesion
27
Q

Dementia has a(n) (abrupt/gradual) onset.

A

Gradual

28
Q

Dementia has a (progressive/fluctuating) course.

A

Progressive

29
Q

Dementia patients present with (impaired/intact) consciousness.

A

Intact

30
Q

Dementia patients present with (impaired/intact) attention abilities.

A

Intact

31
Q

Dementia patients present with a (variable/normal) circadian rhythm.

A

Variable

32
Q

What condition results from decreased or failed resorption of CSF and how does it present? How is it treated?

A

Normal Pressure Hydrocephalus (NPH)

  • Presents with a classic triad of symptoms: (DIG)
    • Dementia
    • Incontinence
    • Gait apraxia.
  • May be treated with a shunt to drain excess CSF.
33
Q

What vitamin is required for the synthesis of myelin? What is the result of a deficiency in this vitamin?

A

Vitamin B12 (Cobalamin)

Deficiency may lead to:

  • Dementia
  • Degerneration of lateral and posterior spinal columns
  • Megaloblastic anemia (type of macrocytic anemia)
  • Loss of vibritory sensation
  • Increased methylmalonic acid
34
Q

What are three common anticholinesterases used in the treatment of dementia?

A
  • Donepezil
  • Rivastigmine
  • Galantamine
35
Q

______________ is a glutamate receptor blocker theorized to prevent glutamate-mediated cell death via excitotoxicity in dementia patients.

A

Memantine

36
Q

What is the genetic linkage that is associated with Alzheimer’s? What is the method for definitive diagnosis?

A
  • ApoE4 allele genetic linkage
  • Definitive diagnosis is by autopsy with detection of neurofibrillary plaques and tangles

BB Test 4 (14 decks)

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