MOC Exam#7 Flashcards
(30 cards)
Characteristics of Neurocognitive Disorder with Lewy Bodies
- depression prior to onset of memory problems
- fluctuating cognitive performance
- visual hallucinations early in illness
- Parkinsonian symptoms in 70-90%
fluctuating cognitive performance is associated with Parkinson’s disease, Alzheimer’s disease. TRUE or FALSE
FALSE
Bipolar disorder, hirsutism, __________
Valproic acid
The four elements that must be proven present for malpractice to be found
The 4 D’s:
- duty
- dereliction
- damages
- direct cause
The best pharmacological treatment of illness anxiety disorder
- SSRI
- significant rates of remission
Hallmark symptoms of Lewy Body Disease
- vivid visual hallucintations
- fluctuations in levels of alertness (confusion)
- spontaneous Parkinsonism
- onset of cognitive symptoms within 1 year of motor symptoms
Hallmark of neurocognitive disorder due to frontotemporal lobar degeneratiion
-prominent behavioral problems
Rates of Alzheimer’s Disease with age
- 5%-8% over age 65y
- 15%-20% over age 75y
- 25%-50% over age 85y
Association between depression and Alzheimer’s Disease
- people with depression are more vulnerable to AD
- patients with AD tend to have fluctuation symptoms of depression unlike pts without AD
REM Sleep Behavior Disorder (RSBD)
- often associated with “synucleinopathies, Parkinson’s Dz, Lewy Body
- “acting out” on dreams due to lack of normal atonia associated with REM sleep
Features of neurocognitive disorder due to frontotemporal lobar degeneration (FTD)
- apathetic, lacking initiative without reporting depressed mood or anhedonia
- early changes in interpersonal and social behaviors without cognitive symptoms
Features of Creutzfeld-Jakob Disease
- rapidly progressive neurocognitive disorder
- caused by prion
- “spongiform encephalopathy”
- myoclonus
- EEG PERIODIC SHARP WAVE COMPLEXES
- MRI BASAL GANGLIA HYPERINTENSITIES
- CSF positive for protein 14-3-3
Decreased ceruloplasmin levels
- Wilson’s Dz
- disorder of copper metabolism causing hepatoxicity and neurotoxicity in young adults
Neurocognitive Disorders associations:
- Motor Slowing
- Constructional deficits
- Benefit from structural support/cueing
- Impaired semantic fluency and naming
- Perseverative, imitative, utilization behaviors
-Motor Slowing: LEWY BODY
-Constructional deficits: LEWY BODY
-Benefit from structural support/cueing: VASCULAR
-Impaired semantic fluency and naming: ALZHEIMER’S DISEASE
-Perseverative, imitative, utilization behaviors:
FRONTOTEMPORAL
Characteristics of SIADH
- normal to high blood volume
- low serum sodium
- inappropriate excretion of sodium
Psychotropic medications causing SIADH
- Tegretol (Carbamazepine)
- phenothiazines
- TCA’s
- MAOI’s
Which SGA’s are dosage adjustment for renal function recommended?
- Clozapine
- Paliperidone
- Risperidone
- Lurasidone
Which amyloid beta (Abeta) peptide is more pathogenic in Alzheimer’s disease?
Abeta1-42 is more proned to aggregation therefore more pathogenic
Lifetime risk of Alzheimer’s Disease
- at age 65y 9.1% for males, 17.2 % females
- at age 75y 10.2%, 18.5%
- at age 85y 12.1%, 20.3%
Preferred mood stabilizer for rapid-cycling bipolar disorder
-Valproic acid
Risk of SGA’s in elderly
- sensitivity to EPS
- increased risk of stroke
Changes in sleep/wake cylce associated with neurocognitive disorders
- increased fragmentation of sleep
- increased latency for onset of sleep
- decreased sleep efficiency
- decreased total sleep time
- decreased slow-wave sleep
- sleep cycle reversal
- napping during the day
- wandering
- disorientation
- sundowning
The only FDA approved combined oral contraceptive pill for treatment of PMDD
Drospirenone/ethinyl estradiol
Treatments for PMDD
- SSRI’s
- Drospirenone/ethinyl estradiol
