neurocognitive

Question 1

state the hallmark of
Delirium
Dementia

Answer 1

delirium- altered consciousness

dementia - global impairment of intellect

Dementia is the leading risk factor for delirium.

Question 2

what NT implicated in development of Alz dementia

Answer 2

acethylcholine a nd NE - hypoactive

Question 3

chrosomes involved in ALz

Answer 3

ch 1, 14, 21

Question 4

gross brain findings in Alz

Answer 4

gross brain atrophy

hippocampal atrophy

Question 5

Microscopic findings in Alz

Answer 5

senile palques
neuronal loss
synaptic loss
granulovascular degeneration

Question 6

NF tangels can also be seen in :

besides from ALz

Answer 6

Down syndrome
Parkoinsons deementria
dementia pugilitisca
brains of N senile people

Question 7

profile/ risks factors for ALZ

Answer 7

female . with first degree relative

hx of head injury

Question 8

Definitive Dx for CJD

Answer 8

postmortem microscopic examination: spongiform neural degeneration, gliosis cortical and subcoetical gray matter
eeg- rhythmic slow waves and sharp spikes

clinically : rapid progressive cortical pattern dementia
6th-7th decade
nonspecific sy,ptoms: depression, lethargy, fatigue
dementia, myoclonus

risk factors; human transplanrs- corneal, hormone extracts

prognosis : death on 6mosn - 2yrs from dx

Question 9

core features of Lewy bodies

Answer 9

1. fluctuating cognitiom, variations in attentio and alertness
2. visual hallucinations , usually detailed
3. motor symptoms - like PD

2 core - possible
1 core - probable

features supp dx: 
- repeated falls 
- syncope 
- transient loc
neuroleptioc sensitive
sys delusion
hallucination

Question 10

core features of FTD

Answer 10

1. gradual changes in behavior and personality - disinhibition, apathy, limited insight
2. ;progressive language decline

Question 11

how many % of patients with PD have dmeentia

Answer 11

20-30%

Question 12

slowed thinking in pxs PD

Answer 12

bradyphrenia

Question 13

box car ventricles on CT / MRI

Answer 13

Huntungtons dse
- SHORT arm of ch 4
30-40yrs, equal male and female 
boxcar- caudate atrophy
PET- striatal hypometabolism 
associated with emotional changes

Question 14

crietria for mci 
T/ F 
1.memory complaint 
2. objective finding of imapoirement accdg to age and educ 
3. impaired gen cognitive fxns 
4. some prob with ADLS 
5. not demented

Answer 14

1. memory complaint - T
2. objective finding of imapoirement accdg to age and educ - T
3. impaired gen cognitive fxns - F
4. some prob with ADLS =F
5. not demented - T

Question 15

what are the FTDS ?

profile ?

Answer 15

picks dse- pathognomonic Pick bodioes- swollen and pink
progressive nonfluent aphasia
CBD
semantic dementia

ch #17

gross- focal asymm atrophy FT regions
micro- neuronal loss, gliosis and spongiform changes

Question 16

No clear distinction bet early na d late onset ALz but…

Answer 16

early- family hx and rapid progressive course

Question 17

Predisposing factirs to dev delirium

Answer 17

Age >70 
Preop cognitive impairment 
functional limitation - vision 
physical restraints 
Preop use benz, narcotic analgesics 
>3 meds 
epidural use

Question 18

What pharmaco in pxs with acute delirium,?

Answer 18

Haloperdiol IM 0.5-10mg
5-50mg/day, BID

chlorpromazine - not bec of anticholinergic effects
if sec to anticholinergic toxicity - give physostigmine

benz- diaz / barbs- amobarbital- long 1/2 lives- cognitive disorg

Question 19

Average surival expectation in Alz dementria

Answer 19

8 yrs

Question 20

T / F

you cannot dx amnestic disorder in the context of delirium / dementia .

Answer 20

TRUE
amnestic d/o secondary to a sys medical/ primary cerebral dse/ subs/medocatiopn

affected both recall and ability to learn

but intact immediately repeat sequential string of info

Question 21

most common cause etology wise of vascular dementia is …

Answer 21

thromnoembolism, large vessel

Question 22

delirium and dementia, share the FF

Answer 22

dec in ACH
hallucinations, sundowning
NO insight

Question 23

coined the term catastrophic reaction among demented px

Answer 23

Kurt Goldstein

catastrophic reaction- subjection awareness of one’s intellectual defuicit

Question 24

two basic pattern of dementia, diffe them

Answer 24

cortical - ex ALZ
manifesttaion: cognitive, language , calcuatin, exec function

subcortical ex: HD, PD, PSP
mood and personality changees

Question 25

Most common casue of dementia in ages 14-24?

Answer 25

Head injury closed head injury 3rd most common cause dementia for <50yrs