B&b Quiz 3: Dementia

Front 1

Cognitive Disorders

Back 1

A group of disorders of memory, orientation, level of consciousness, or executive functioning

Front 2

Dementia

Back 2

Gradual loss of intellectual ability without impairment of consciousness

Front 3

Alzheimer's Disease

Back 3

A dementia characterized by prominent memory loss and word-finding difficulty w/o motor impairment. Late behavioral changes.

Front 4

Pathological bases for AD

Back 4

Cortical atrophy (esp parahippocampal) w/ hydrocephalus ex vacuo. EC beta-amyloid plaques and cytoplasmic neurofibrillary tangles of tau protein. **tau distribution correlates w/ dz severity.

Front 5

Apolipoprotein E (apo E)

Back 5

Protein involved in cholesterol metabolism whose allele (E4) is associated with increased risk of AD.

Front 6

Amyloid Precursor Protein (APP)

Back 6

Large protein from which B-amyloid is derived- mutation associated with early-onset AD. Found on Chrom 21.

Front 7

Presenilin

Back 7

Gene associated with early onset AD; found on Chrom 14

Front 8

Making the dx: AD

Back 8

Clinical dx. Brain Imaging, Test to r/o B12, folate, TSH, urine drug screen

Front 9

Vascular Dementia

Back 9

Dementia caused by many small brain infarctions. Stepwise pattern of decline, with sudden onset or increases in symptoms. Focal neurologic signs common

Front 10

Lewy Body Dementia

Back 10

Dementia characterized by fluctuating cognition, hallucinations and Parkinsonian movement disorders.

Front 11

Lew Body path

Back 11

Intracytoplasmic alpha-synuclein inclusions in a small # of neurons, mainly in the cingulate cortex.

Front 12

Pick Disease

Back 12

Type of frontemporal lobar degeneration characterized by loss of frontal executive function and early disruptive and inappropriate behavior

Front 13

Pick Disease path

Back 13

Frontotemporal atrophy. Pick Bodies seen in remaining neurons -- cytoplasmic inclusions made up of tau proteins.

Front 14

HIV Dementia

Back 14

Dementia caused by direct brain infection by the virus and resulting atrophy and demyelination. An ominous prognostic sign.

Front 15

Amnestic Disorder

Back 15

Memory loss without other cognitive impairments

Front 16

Pseudodementia

Back 16

Dementia-like manifestation of depression in the elderly. Treatable.

Front 17

Classes of drugs used for dementia

Back 17

Cholinesterase Inhibitors, Glutamatergic Antagonists

Front 18

Cholinesterase Inhibitors

Back 18

Block breakdown of CNS synaptic Ach, prolonging its effects. Donepezil, Rivastigmine, Galantamine

Front 19

Donepezil

Back 19

Centrally acting cholinesterase-inhibitor used for all stages of dementia

Front 20

Rivastigmine

Back 20

Centrally acting cholinesterase-inhibitor used for mild/moderate AD, Parkinson's dz dementia

Front 21

Galantamine

Back 21

Centrally acting cholinesterase-inhibitor used to treat mild/moderate dementia

Front 22

Primary side effects of central cholinesterase inhibitors

Back 22

NVD, anorexia

Front 23

secondary side effects of central cholinesterase inhibitors

Back 23

insomnia, vivid dreams, bradycardia, syncope

Front 24

Glutamatergic Antagonists

Back 24

antagonize NMDA receptor, relieving excitotoxicity. Memantine

Front 25

Memantine

Back 25

Glutamatergic Antagonist used to treat moderate/severe AD

Front 26

Memantine side effects

Back 26

headache, constipation, agitation

Front 27

Memantine drug interactions

Back 27

decreases metabolism of buproprion, trihexyphenidyl.

Front 28

Delirium

Back 28

A syndrome of waxing and waning impairment of consciousness. Often oriented to person, inattentive. Can progress to dementia/death.

Front 29

What can cause delirium

Back 29

Acute illness, substance abuse/withdrawal, fever, post-op, anticholinergic meds, pain, dehydration, polypharmacy

Front 30

Delirium Tremens

Back 30

Alcohol withdrawal delirium, usually on 3rd day of withdrawal in pts who drank heavily 5+ years. 20% mortality.

Front 31

Prevention strategies

Back 31

Keep pt oriented, cognitively stimulated, nonpharmacologic sleep aids for pts w/ insomnia,
keep pt mobile, don't use restraints, visual/hearing aids, avoid dehydration.

Front 32

Treating delirium

Back 32

treat underlying cause, orient pt, neuroleptic meds like haloperidol, or a benzo

Front 33

Neurodegenerative Disease

Back 33

Disorder involving death of functionally related neurons

Front 34

alpha synuclein

Back 34

the abnormal protein seen in Lewy Bodies

Front 35

beta amyloid

Back 35

the abnormal protein in senile plaques

Front 36

Lewy Bodies

Back 36

abnormal cellular inclusions made up of alpha synuclein and associated with Parkinson's Disease and Lewy Body Dementia. **halo