OME - Dementia

Question 1

DDx memory loss?

Answer 1

1. Dementia
2. Amnesia
3. Delirium

Question 2

Presentation dementia?

Answer 2

1. Cognitive impairment - loss ADLs / executive function
2. Memory Loss
3. Slow onset: chronic course

Question 3

Presentation amnesia?

Answer 3

1. No cognitive impairment

2. Only Memory loss

Question 4

Presentation delirium?

Answer 4

1. Cognitive impairment
2. Memory Loss
3. Rapid onset: waxes and wanes

Question 5

Score on MMSE indicative of dementia / cognitive impairment?

Answer 5

Less than 22

Question 6

What is mild cognitive impairment?

Answer 6

1. MMSE positive for impairment

2. ADLs / executive function not impacted

Question 7

Reversible imitators of dementia? Test to rule out?

Answer 7

1. Hypothyroidism: TSH / T4
2. BMP: Cr/BUN
3. Cirrhosis: LFTs:
4. B12
5. Depression
6. Syphilis

Question 8

Preferred imaging in Dementia?

Answer 8

CT

Question 9

Most common for dementia?

Answer 9

Alzheimer’s disease

Question 10

Pathology Alzheimer’s?

Answer 10

Plaques and tangles

Associated with chromosome 21

Question 11

Presentation Alzheimer’s?

Answer 11

1. ST memory goes first, then LT
2. Elderly, slow onset
3. Usually spares social graces

Question 12

CT alzheimers?

Answer 12

Diffuse cortical atrophy

Question 13

Rx Alzheimer’s?

Answer 13

1. Supportive care

2. Family education

Question 14

Presentation Frontotemporal degeneration?

Answer 14

“Pick’s Disease”

1. Personality Goes first: NO FILTER
2. Memory retained at first
3. Hypersexual
4. Hyper Aggressive

Question 15

Imaging Picks?

Answer 15

Frontotemporal degeneration

Question 16

Presentation Lewy body dementia?

Answer 16

1. Parkinsonian symptoms - only a few symptoms
2. Dementia - predominates
3. Visual hallucinations

Question 17

MRI with loss of substantia nigra and dementia?

Answer 17

Picks disease

Question 18

Presentation Vascular dementia?

Answer 18

1. Stepwise decline with each stroke with each stroke

2. Alzheimer

Question 19

Difference in vascular dementia and alzheimer’s?

Answer 19

• Alzheimer’s is a gradual decline

- Vascular is a step down with each stroke

Question 20

Pathology CJD?

Answer 20

Prions / undercooked meat / mad cow

- Most often from a sporadic mutation

Question 21

Presentation CJD?

Answer 21

1. Extremely young dementia

2. MYOCLONUS

Question 22

Diagnosis CJD?

Answer 22

MRI

Question 23

Prognosis CJD?

Answer 23

Usually die in six months

Question 24

Pathology NPH?

Answer 24

1. Increased ICP

Question 25

Presentation NPH?

Answer 25

1. Wet - urinary incontinence 2. Wobbly - Ataxia 3. Weird - Dementia

Question 26

Diagnosis NPH?

Answer 26

1. CT showing hydrocephalus | 2. LP with symptoms improving