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29 Cards in this Set

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  • Back
what are some of the early neurologic (primitive) findings commonly found in an alzheimers dz?
palmar grasp, plantar grasp, such reflex, snout reflex, rooting reflex, and the glabellar reflex.
what portion of the brain is responsible for controlling us as far as primitive reflexes?
the cortex, especially the frontal.
what are some of the findings for a moderate Alzheimer's pt?
cant recognize close friends and family, disorientation to time and place, confusion, anxiety, insomnia, social graces lost.
how long are pt's usually in the mild Alzheimers category?
2-4 years
how long are pt's usually in the moderate Alzheimers category?
2-8 years
what are the categories that we look at for orientation? and what order are they lost in?
time (lost first), place (2nd lost), self (knowing who they are, last to be lost). Record 0x3,0x2,0x1 or disoriented.
What are some of the clinical findings of "severe" Alzheimer's pt?
they cant remember anything or process new information, dont understand words (but they will respond to touch, music, and eye contact), speech disorders, aprxia (inability to perform coordinated movement), visuospatial disorientation, they are often bedridden.
How long is a person usually in the severe category for Alzheimer's, and what do they usually succumb to?
they are usually in the severe category for 1-2 years and then usually succumb to pneumonia.
what are some of the differential diagnosis that you need to think about when you might have an Alzheimer's pt?
pseudodementia of depression, stroke (is usually static dementia), parkinsons disease (mild),Alcoholoism and acute thyamine deficiency, gastrointestinal conditions that cause absorption problems, drug induced delirium.
what is the name a memory loss due to alcoholism and acute thyamine defficiency?
wernicke korsikoff
what are the more popular ways of preventing Alzheimer's?
- Low fat diet and increased fish consumption, statin drugs have been show to help
- Exercise
- education and complex work
- word game.
who "goes down hill faster" educated or non-educated people?
educated people don't get it until later in life then they fall fast.
what class of drugs used for Alzheimers disease is suggested to improve cognitive function in mild to moderate disease and how does it work?
cholinesterase inhibition, it keeps ACh around longer.
what drug is taken bid for neuroprotection in moderate to severe Alzheimer's
memantine
What does memantine do in a general sense to help Alzheimers pts?
the neurons become sensitive to glutamate , this blocks out glutamate, reducing the "noise" and allowing good signals to get through.
tandem use of memantine and what slows the progression of AD?
in addition to a cholinesterases like donepzil
Selegiline is a drug that inhibits MAO-B what is this and how does it help AD pt's?
MAO-B is an enzyme that breaks down dopamine. inhibition of this allows more dopamine to stay around longer.
when looking at monoclonal antibodies (the alpha, Beta, and Gamma) what do you want to regulate in relation to the others?
gamma, if alpha is active then you want gamma, if beta is active then you dont want it. (active alpha=good)
what does AD do to the remaining life span of a person?
roughly cuts it in half. men die sooner
what are some of the future therapies for AD
IV gamma globulin, methyonium chloride and dimebon worked before but they cant replicate.
visual variant Alzheimer's disease is also known as what?
posterior cortical atrophy
what is usually seen in visual variant Alzheimer's dz?
affects are seen in the occipital lobe, older people start having accidents so the kids bring them in b/c they think it is a visual problem.
what are some initial symptoms seen with visual variant Alzheimer's dz?
initial symptoms are visual
-reading and driving difficulties
-can see, but cant recognize (i cant read, but i see just fine)
-difficulty recognizing faces or objects
-difficulty with depth perception
-standard optometric exam appears normal.
is a pt's insight affected with visual variant AD?
no their insight is not affected so they know what is going on. therefore depression is a problem.
if you show a patient a picture of Elvis and they do not recognize him, then you play his music and they do recognize him what would you expect? this is know as prosopagnosia.
visual variant dz.
ocular apraxia is associated with VVAD what is it?
when a person cant generate effective saccades
visual object agnosia is associated with VVAD what is it?
when a person cant recognize an object by sight but can by touch or sound.
what will a person with VVAD do when you show them a picture that has many things going on in it?
they will only see on thing and you will have to ask them to find another thing going on.
-drawing a clock is also a good test.
what type of dementia is caused from successive strokes with an underling problem of HTN, DM, or hyperlipidemia
multi infarct dementia.