Dementias, MacIntyre Flashcards Preview

Year 2 Psych exam I > Dementias, MacIntyre > Flashcards

Flashcards in Dementias, MacIntyre Deck (49):
1

top 3 causes of dementia

alzheimers
vascular
lewy body

2

majority dementia presents when

>90 y.o
15-20% >85 y.o

3

dementia reclassified as

neurocognitive disorders

4

what is essential in Dx dementia

not due to delirium or other mental Dx

5

major vs mild dementia

major interferes with ADLs (not independent)

6

what cognitive domains decline in dementia

complex attention
executive function
learning/memory
language
perceptual motor
social cognition

7

what cognitive domains decline in dementia

complex attention
executive function
learning/memory
language
perceptual motor
social cognition

8

signs of dementia

aphasia
agnosia
apraxia
progressive onset
no clouding of consciousness

9

which dementia can have clouding of consciousness

lewybody

10

NT in alzheimers

cholinergic neurons loss
dec Ach

11

avoid what medsin dementia

anticholinergics!!!

12

medical workup in dementia

VITAL signs
Hx and PE
cognitive testing
labs
neuroimaging when indicated

13

what labs to order for dementia

CBC, CMP, HIV/Syphilis tests, ammonia, thyroid, B12/Folate, UA, EKG, CXR

14

differential in dementia

delirium
pseudodementia
benign senescent forgetfullness
medical illness

15

what are reversible dementias

B12 deficiency
folate deficiency
tumor
infection
subdural hematoma
NPH

16

autopsy findings alzheimers

atrophy and enlarged ventricles

17

risk factors for alzheimers

downs APP
female sex
head trauma Hx
lower education level
ApoE alleles

18

what chromosomes may be assoc with alzheimers

1, 14, 21

19

what alleles assoc with alzheimers

ApoE e4 increase
ApoE e2 protective

20

accumulation of what in alzheimer

amyloid plaques and tau tangles

21

plaqu in alzheimer

APP amyloid B42

22

tangles in alzheimer

phosphorylated tau
intracell accumulation

23

clinical signs of alzheimers

behavioral
psychosis! depression, agitation!!!!
sundowning (wander at night)

24

careful Tx alzhemier because

elderly are sensitive to side effects etc
start low go slow

25

Tx alzheimer drug classes

ACHEI
memantine (NMDA R blocker)
antipyschotics
valproic acid
SSRI

26

ACHEI used in alzheimer

donepezil
rivastigmine
galantamine

27

avoid benzos why in alzheimer

inc risk dementia
INC risk for falls!!!
addiction
cannot detox elderly who are addicted

28

vascular dementia

onset relates to CVA and decline prominent in complex attention and frontal/executive function

29

demographics vascular dementia

more common in men
abrupt onset step wise decline

30

clinical signs vascular dementia

dysrhythmia, murmurs, bruits,

31

risk factors for vascular dementia

smoking, BP, glucose, aspirin

32

Tx vascular dementia

control risk factors
can try ACHEI

33

Presentation frontotemporal dementia

insidious onset/gradual progression
behavioral or language types
**overreaction!!

34

demographics frontotemporal dementia

men>women
usually in 50s
earlier onset

35

Tx frontotemporal dementia

ACHEI or mood stabilizers(aggression)

36

Lewy Body dementia overlaps with

PD

37

signs of lewy body dementia

psychosis (visual hallucinations!!!)
parkinosonian features
fluctuating mental function looks like delirium
paradoxical antipsychotic Tx reaction!!!

38

what is the paradoxical antipsychotic Tx reaction

inc psychosis and inc side effects with Tx ine lewy body

39

CJD

prion disease
clonus, ataxia, biomarker evidence
triphasic waves on EEG
Tx supportive, rapidly fatal

40

Chronic Traumatic Encephalopathy marked by

impulsivity, dysarthria, emotional lability

41

Tx CTE

ACHEI
valproic acid
sSRI
avoid anticholinergics!

42

abulia

lack of motivation, seen in HD

43

what funciton go away first in HD

complex tasks
memory and language later

44

Tx HD

antipsychotics, ACHEI, mood stabilizers, SSRI

45

PD accumulates what

alpha synuclein or tau protein in substantia nigra
have lewy bodies

46

Tx PD

dopaminergic agents---- can cause psychosis!!!

47

how to distinguish lewy body and PD

PD requires cognitive decline >1 year Dx of PD

48

dementia from HIV

neurtoxicity of HIV macrophages

49

dementia in MS

can be seen, multiple lesions everywhere!!