Dementia

Question 1

Frontotemporal dementia is also known as

Answer 1

Pick’s Dz

Question 2

Extracellular plaques

Answer 2

amyloid

Question 3

Intracellular tangles

Answer 3

tau

Question 4

These deficits are associated with cognitive impairment, agitation, aggression, especially in nucleus basalis, hippocampus, and frontotemporal regions

Answer 4

Cholinergic deficits

Question 5

These deficits are associated with depression, agitation, aggression and impulse dsycontrol esp with cell loss in raphe nucleus and long 5-HT transporter gene

Answer 5

Serotonergic deficits

Question 6

These deficits may impact sensitivity to developing spontaneous and drug-induced movement disorders

Answer 6

Dopaminergic deficits

Question 7

Dementia is now called

Answer 7

Neurocognitive Disorder

*DSMV

Question 8

Executive functioning is not included in this exam

Answer 8

Mini Mental Exam

Question 9

Neurocognitive disorders are often noticed first how?

Answer 9

Activities of Daily Living

Question 10

Pts self-report this impairment

Answer 10

Mild Cognitive Impairement

Question 11

60-70% of dementias. Uncommon b4 60. Rises steeply after 60

Answer 11

Alzheimer’s

Question 12

Often misdiagnosed as Alzheimer’s

Answer 12

Vascular dementia

Question 13

If you suspect dementia, start with MME and then move to which test?

Answer 13

MOCA

Question 14

Sudden behavior changes, 40-60yo, loss of ability to communicate effectively, very rare

Answer 14

Frontotemporal dementia

Question 15

Visual hallucinations. Cognitive impairment first, followed by motor impairment

Answer 15

Lewy body dementia

Question 16

Caused by build up of apha synuclein

Answer 16

Lewy body dementia

Question 17

Motor impairment first, followed by cognitive impairment

Answer 17

Parkinson’s

Question 18

Most important skill before giving a cognitive assessment tool

Answer 18

Build repoire!

Question 19

Score range for MMSE

Answer 19

0 to 30

Question 20

MMSE Normal Cognitive Fxn

Answer 20

27 to 30

Question 21

MMSE Mild Cognitive Impairment

Answer 21

21 to 26

Question 22

MMSE Moderate Cognitive Impairment

Answer 22

11 to 20

Question 23

MMSE Severe Cognitive Impairment

Answer 23

0 to 10

Question 24

Gold standard for Cognitive Assessment

Answer 24

MMSE

Question 25

10 mins to administer

Answer 25

MMSE

Question 26

Cutoff Score for MMSe

Answer 26

24/30

Question 27

More sensitive than MMSE; use if concern for mild cognitive impairment

Answer 27

MOCA

Question 28

MOCA Normal Cognitive Fxn

Answer 28

>26

Question 29

MOCA Cognitive Impairment Avg

Answer 29

22

Question 30

MOCA Alzheimer's Avg

Answer 30

16

Question 31

Use for triage only

Answer 31

Mini Cog

Question 32

3-5 mins, good executive fxn assessment, not affected by language or education level

Answer 32

Mini Cog ``` spec = 99% sens = 93% ```

Question 33

"10 past 11"

Answer 33

Mini Cog

Question 34

recall 3 words

Answer 34

Mini Cog

Question 35

If they recall 1 or 2 words, then . . .

Answer 35

Look at the clock

Question 36

Abnormal clock + 1 or 2 words recall = ?

Answer 36

Suggest cognition deficit according to MiniCog

Question 37

Cognitive reserve means

Answer 37

lots of resilience to behavior problems seen in cognitive impairment

Question 38

Can do normal motor memory routine activities

Answer 38

Macro

Question 39

These impairments show during stress

Answer 39

Micro

Question 40

Driving test can tell difference between these two things

Answer 40

Macro vs Micro

Question 41

This exam is not diagnostic

Answer 41

MIni Cog

Question 42

Risk factors for Alzheimer's

Answer 42

Increased age, female, Bad brains, other Dz, Mental illness

Question 43

Alzheimer's genes

Answer 43

Chromosomes 1, 10, 12, 14, 19 (APOE e4), 21

Question 44

Donepezil (Aricept) Rivastigmine (Exelon patch) Galantamine (Razadyne)

Answer 44

Acetylcholinesterase inhibitors

Question 45

Memantine (Namenda)

Answer 45

NMDA antagonist *glutamate

Question 46

2 NTs needed for learning and memory

Answer 46

glutamate and Ach

Question 47

Remember: AChEI's have the potential to increase pulmonary secretions slow hear rate via

Answer 47

peripheral cholinergic activation

Question 48

How do you give drugs

Answer 48

Give low, go slow

Question 49

When giving antipsychotics you must . .

Answer 49

Document *There is a BBW