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Year 2 Psych exam I > Dementias, MacIntyre > Flashcards

Dementias, MacIntyre Flashcards

(49 cards)

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1
Q

top 3 causes of dementia

A

alzheimers
vascular
lewy body

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2
Q

majority dementia presents when

A

> 90 y.o

15-20% >85 y.o

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3
Q

dementia reclassified as

A

neurocognitive disorders

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4
Q

what is essential in Dx dementia

A

not due to delirium or other mental Dx

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5
Q

major vs mild dementia

A

major interferes with ADLs (not independent)

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6
Q

what cognitive domains decline in dementia

A 
complex attention
executive function
learning/memory
language
perceptual motor
social cognition
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7
Q

what cognitive domains decline in dementia

A 
complex attention
executive function
learning/memory
language
perceptual motor
social cognition
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8
Q

signs of dementia

A 
aphasia
agnosia
apraxia
progressive onset
no clouding of consciousness
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9
Q

which dementia can have clouding of consciousness

A

lewybody

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10
Q

NT in alzheimers

A

cholinergic neurons loss

dec Ach

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11
Q

avoid what medsin dementia

A

anticholinergics!!!

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12
Q

medical workup in dementia

A 
VITAL signs
Hx and PE
cognitive testing
labs
neuroimaging when indicated
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13
Q

what labs to order for dementia

A

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

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14
Q

differential in dementia

A

delirium
pseudodementia
benign senescent forgetfullness
medical illness

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15
Q

what are reversible dementias

A 
B12 deficiency
folate deficiency
tumor
infection
subdural hematoma
NPH
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16
Q

autopsy findings alzheimers

A

atrophy and enlarged ventricles

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17
Q

risk factors for alzheimers

A 
downs APP
female sex
head trauma Hx
lower education level
ApoE alleles
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18
Q

what chromosomes may be assoc with alzheimers

A

1, 14, 21

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19
Q

what alleles assoc with alzheimers

A

ApoE e4 increase

ApoE e2 protective

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20
Q

accumulation of what in alzheimer

Study These Flashcards
A

amyloid plaques and tau tangles

21
Q

plaqu in alzheimer

Study These Flashcards
A

APP amyloid B42

22
Q

tangles in alzheimer

Study These Flashcards
A

phosphorylated tau

intracell accumulation

23
Q

clinical signs of alzheimers

Study These Flashcards
A

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

24
Q

careful Tx alzhemier because

Study These Flashcards
A

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!!

Year 2 Psych exam I (15 decks)

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