dementia

Question 1

dementia vs. depression

Answer 1

decreased attention 
memory impairment 
apathy 
social withdrawal 
dont engage "i dont know"

Question 2

personality changes in dementia

Answer 2

paranoia
disinhibition
socially inappropriate

Question 3

risk factors dementia

Answer 3

age 
family hx 
head injury 
heart disease 
hereditary (APOE-e4)

Question 4

praxis ex.

Answer 4

combing hair with toothbrush

Question 5

folsteins MMSE
what does it contain?
scoring?

Answer 5

orientation 
registration
attention and calculation 
recall
language
1 point each correct answer
total= 30 points

Question 6

Mini cog
what does it contain?
scoring?

Answer 6

3 item recall and clock drawing
0-5
0-2 = dementia

Question 7

only definitive dx test for dementia

Answer 7

biopsy

Question 8

MRI dementia- not in who?

Answer 8

stent pacemaker joint replacement

Question 9

Presentation frontotemporal dementia aka

Answer 9

frontotemporal dementia aka picks dx

damage in frontal and temporal–> hitting, personality changes, language impairment

Question 10

Presentation dementia with lewy bodies

Answer 10

similar to alzheimers, fluctuating *
hallucinations* jerks
presents like parkinsons

Question 11

Presentation of normal pressure hydrocephalis

dx?

Answer 11

dips drips dementia

dx: spinal tap, surgical shunt

Question 12

Creutzfeldt-jacob

Mixed dementia

Answer 12

mad cow dx, fatal

mixed: ie vascular and parkinsons

Question 13

Vascular dementia: 
\_\_\_ most common 
formerly known as \_\_\_\_\_
lesion is \_\_\_\_\_\_ 
risk factors
presentation

Answer 13

2nd most common
formerly known as multiple infarct dementia
defining lesion is lacunar infarct
risk factors: HTN, smoking, cholesterol, PVD, CVD, diabetes
presentation: abrupt, stepwise, executive dysfx, gait change
have reality base

Question 14

Alzheimers
_____ and _____
characterized by ______ and ______
brain atrophy of _____

Answer 14

progressive and fatal
char. by amyloid plaques and neurofibrillary tangles in the brain
brain atrophy of cerebral cortex (pronounced frontal, temp, parietal)

Question 15

Frontal lobe:
Temporal lob:
Occipital:

Answer 15

frontal: behavior, emotion, problem solving
temporal: memory, word understanding
occipital: vision

Question 16

MMSE 
Mild (preclinical)
Early, mild 
Middle moderate 
severe

Answer 16

Mild: 26-30
Early mild: 21-25
Moderate: 11-20
Severe: 0-10

Question 17

Mild cognitive impairment

Answer 17

no functional impairment
may not progressive past this stage
reported by caregiver
(26-30)

Question 18

Early, mild impairment

Answer 18

when you see in office
finances 
decreased insight r/o depression 
disoriented to date 
anomia (diff. naming)
(21-25) 1-3 years after onset of sx

Question 19

Middle moderate

Answer 19

disoriented to time/place
cant express learn new things 
cant cook clean shop 
behaviors worsen: restless, anxious, depressed, delusions, aggression
get lost
aphasia (cant comprehend)
(11-20) lasts 2-8 years

Question 20

Severe impairment

Answer 20

unintelligible verbal output 
cant write or copy 
cant groom dress 
incontinent 
(0-10) can last 6-12 years

Question 21

Treatment principles 
\_\_\_\_ prophylaxis for vascular and mixed dementia 
avoid \_\_\_\_\_\_ medications such as 
limit\_\_\_\_medications
avoid \_\_\_\_\_ telling

Answer 21

stroke prophylaxis for vascular and mixed dementia
avoid anticholinergic medication (benztropine, benadryl, hydroxyzine, oxybutynin, tricyclic antidepressants, clozapine, thioridazine)
limit prn psychotropic medications
avoid truth telling

Question 22

Dementia treatment

pharmacologic

Answer 22

Cholinesterase inhibitors (donezipil/aricept, galantamine/razadyne, rivastigmine/exelon)
NMDA receptor antagonists (memantine/namenda)