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49 Cards in this Set
- Front
- Back
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% of demented people with delusions/hallucinations?
wit depression and anxiety? |
30%
40-50% |
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3 leading causes of dementia
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alzheimers (50-60%
vascular 10-20% pseudodemntia with depression (15%) |
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workup for dementia
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CBC
electrolytes TFTs VDRL/RPR B12 and folate Brain CT or MRI |
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dementia with stepwise increase in severity
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multi-infarct dementia
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demetia
cogwheel rigidity resting tremor |
lewy body dementia
Parkinson's disease |
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dementia
ataxia urinary incontinence dilated cerebral ventricles |
normal pressure hydrocephalus
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dementia
obesity coarse hari constipation cold intolerance |
hypothyroidism
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test for dementia 2/2 hypothyroid
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T4, TSH
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dementia
diminished position and vibration sensation megaloblasts on CBC |
B12 deficiency
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dementia
tremor abnormal liver function tests Kayser Fleishcer rings |
Wilson's disease
test with cruloplasmin |
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dementia
diminished position and vibration sensation Argyll robertson pupils |
neurosyphilis
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two types of delirium
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quiet (differentiate from depression!)
agitated |
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disorder of language, speaking and understanding
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aphasia
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disorder of not being able to do things
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apraxia
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inability to recognize tings previously known
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agnosia
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life expectancy after diagnosis of alzheimers
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8 years
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% of alzheimers patients with family history
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40%
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NT lacking in alzheimers
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ACTH
NE |
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why is ACTH low in alzheimers
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loss of NE neurons in locus ceruleus
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why is NE low in alzheimers
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preferential loss of cholinergic neurons in nucleus basalis of meynert
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what kind of meds aare tacrine, donepezil, rivastigmine
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cholinesterase inhibitors
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what is memantine
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an NMDA receptor antagonist
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rx to treat agitation/psychosis in alzheimers
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quetiapine
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criteria for Alzheimers
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memory impairment plus 1 of:
aphasia apraxia agnosia dminished executive functioning (same as for vascular dementia) |
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aphasia
apraxia agnosia personality and behavioral changes prominent early in disease |
Pick's disease, frontotemporal dementia
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atrophy of frontotemporal lobes
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pick's disease
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chromosome for Hungtington's
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4
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caudate atrophy (sometimes cortical atrophy)
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Huntington's disease
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cortical dementias
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alzheimers
Pick's CJD |
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subcortical dementias
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Huntington's
Parkinsons NPH multi-infarct (more affective and movement symptoms) |
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clinical manifestations of parkinsons
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bradykinesia
cogwheel rigidity resting tremor, pill rolling mask facies shuffling gait dysarthria |
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difference between levodopa and carbidopa
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levo crosses the BBB where it can be converted to dopamine
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mechanism of levodopa
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degraded to dopamine by dopadecarboxylase
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mechanism of carbidopa
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prevents levodopa from being converted to dopamine before it reaches the brain by inhibiting periperal dopadecarboxylase
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mechanism of MAOIs in parkinson's
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inhibit BAO-B, which inhibits breakdown of dopamine
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type of med that selegiline is
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MAOB inhibitor used in parkinsons
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rapidly progressive dementia 6 to 12 months after onset of symptoms
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CJD
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spongiform changes of cerebral cortex
neuronal loss hypertrophy of glial cells |
CJD
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myoclonus
cortical bindness ataxia muscle atrophy mutism |
CJD
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gait disturbance
urinary incontinence dementia |
NPH (treatable with shunt)
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how to treat normal pressure hydrocephalus
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shunt
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causes of delirium
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I'M DELIRIOUS
Impaired deliery (vascular insufficiency) Metabolic Drugs Endocrinopathy Liver disease Infrastructure (structural disease of cortical neurons) Renal failure Infection Oxygen Urinary tract infection Sensory deprivation |
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delirium
hemiparesis |
CVA
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delirium
hypertension papilledema |
hypertensive encephalopathy
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delirium
dilated pupils tachycardia |
drug intoxication
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delirium
fever nuchal rigidity photophobia |
meningitis
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delirium
tachycardia tremor thyromegaly |
thyrotoxicosis
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tx for delirium
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FEUD
Fluids/nutrition Environment Underlying cause Drug withdrawal |
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what drugs not to use in a delirious patient
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benzos, which exacerbate delirium
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