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6 Cards in this Set
- Front
- Back
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What is the suggested workup for dementia?
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-diagnostic interview (from pt. and another reliable source)
-office based clinical assessment: physical exam, MMSE, neurological exam, lab evaluation, imaging studies, EEG -neuropsychologic testing is diagnosis is unclear |
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What is the cause of Alzheimers? What is the onset? The risk of getting AD is increased with what? When is the definitive diagnosis made at?
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-dont know the cause!
-risk is increased with individuals who carry the ApoE4 allelle -definitive diagnosis is made at autopsy! |
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Development of cognitive defects in AD is manifested by what?
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-memory impairment along with: aphasia, apraxia, agnosia, disturbance in executive functioning (reasoning). Also see social or occupational impairment
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What are the expectations of AD medications?
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-improve, maintain or slow the decline
-control troublesome behavior -ease loss of independence -help caregiver -delay placement in a home |
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What should be the role of the caregiver for all 3 stages of the disease? mild moderate and advanced
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-mild: mostly supportive, reassurance, monitor activities, insure affairs are in order (ex. will), allow as much independence as possible.
-moderate: driving resticted, closer supervision, caregiver should take over financial affairs, monitor hygiene and nutrition, inform physician of concerning behaviors -Advanced: may need to put in a home, 24 hour surveillance, will have to assis in ALL activities of daily living |
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How would a pt. present with amyotrophic lateral sclerosis? (aka lou gherigs disease) What will be most important for evaluation?
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-the defective gene codes for superoxide dismutase. We dont know what causes this though.
-you see both upper and lower motor neuron abnormalities. Upper: atrophy, fasiculations and weakness. Lower: spasticity, hyperactive reflexes -pt. may present with difficulty swallowing or speaking. Rarely affects ocular muscles, sphincters. Sensation and cognigiton ARE NOT affected -get an MRI of the cervical spine to look for STENOSIS. For electrodiagnostic studies, nerve conduction will be normal, electromyography will show evidence of diffuse dennervation -side note: for ALS treatment you have to get social services involved |
