Term
|
Definition
| Impairment of intellectual/cognitive function of sufficient severity to interfere with social or occupational activites |
|
|
Term
|
Definition
| Clouding of consciousness, with reduced capacity to shift, focus, and sustain attention to environmental stimuli |
|
|
Term
| Is Dementia a disease or a symptom? |
|
Definition
symptom
(eventhough there are DSM IV Dx criteria) |
|
|
Term
| What are the DSM-IV Diagnostic criteria fro Dementia? |
|
Definition
1. Impaired short and long-term memory
and/or
2. One of the Following
a. Impaired abstract thinking
b. Impaired judgment
c. other disturbance
3. Disturbances in 1 or 2 interferes with work or ADL
4. symptoms not occurring exclusively during delirium
5. Either:
a. evidence of organic cause
b. exclusion of non-organic mental disorder |
|
|
Term
| What are the DSM-IV Diagnostic criteria for Delirium? |
|
Definition
1. Disorientation and memory impairment
2. Two of the following:
a. Perceptual Disturbances
b. Incoherent Speech
c. sleep-wakefulness cycle disturbances
d. increased/decreased psychomotor actvity
3. Acute Clinical Features - flucuate
4. Evidence of Organic disturbance |
|
|
Term
| What has key features of cognitive deficit in multiple domains that interferes with daily life, deterioration over months to years, and No disorder of alertness? |
|
Definition
|
|
Term
| What has key features of an acute disorder, with deterioration over days to weeks, with flucuating altered level of consciousness, excitable,delusions, and hallucinations? |
|
Definition
|
|
Term
| What are the Clinical characteristics of Delirium? |
|
Definition
Acute Onset
Fluctuating Course
Days/Weeks
Altered Consciousness
Distracted
Hyperactive
Confused
Usually reversible |
|
|
Term
| what are the clinical characteristics of Dementia? |
|
Definition
Insidious onset
Progressive Course
Months/Years
Consciousness Not impaired
Attention Normal
Normal Autonomic function
Impoverished Cognition
Usually irreversible |
|
|
Term
| What are the Causes of Dementia I? |
|
Definition
Neurodegenerative Diseases
Vascular Dementia
Head Trauma
Drugs, Toxins, Ethanol
Brain Tumors |
|
|
Term
| What are the top 2 Neurodegenerative Diseases? |
|
Definition
Alzheimer's Disease - (50-60%)
Dementia with Lewy Bodies - (10-15%) |
|
|
Term
| What are the Causes of Dementia II? |
|
Definition
Normal Pressure Hydrocephalus
Infection
Metabolic Disorders
Nutritional |
|
|
Term
| What are the neuropathological findings of Alzheimer's Disease? |
|
Definition
Loss of cerebral cortical neurons
Neuritic plaques containing B-amyloid
Neurofibrillary tangles |
|
|
Term
| What are the essential criteria for diagnosing Alzheimer's Disease? |
|
Definition
Neuropsychological tests
Deficits in memory + areas of cognition
Progressive worsening of memory + one other cognitive function
No disturbances of consciousness
Onset 40-90 YO
Absence of other brain disease |
|
|
Term
| What are the cardinal features of Alzheimer's Disease? |
|
Definition
Insidious onset
progressive course
early memory loss |
|
|
Term
| How can Alzheimer's Disease be diagnosed premorbidly? |
|
Definition
purely clinical
(no definitive laboratory test) |
|
|
Term
| How is Alzheimer's Disease diagnosed Postmortemly? |
|
Definition
Histological Evidence:
Neuritic plaques
Neurofibrillary tangles
Neuron loss |
|
|
Term
| Where can atrophy be found in the brain of a patient with Alzheimer's? |
|
Definition
Parietal and Dorsal Frontal Temporal Lobe
Less severe Frontal pole |
|
|
Term
| What are Neuritic plaques? |
|
Definition
| Composed of dystrophic neurites containing tau aggregates mostly in straight filament form, surrounding a core of extra cellular amyloid |
|
|
Term
| What are Neurofibrillary tangles? |
|
Definition
| Cortical pyramidal cells filled with aggregated hyperphosphorylated tau protein |
|
|
Term
| What are characteristic findings in a Bielschowsky stain of human cortex form an Alzheimer's disease patient? |
|
Definition
Neuritic Plaques
Neurofibrillary tangles |
|
|
Term
| Where is the highest abundance of Neuritic Plaques? |
|
Definition
|
|
Term
| Where is the highest abundance of Neuritic Plaques? |
|
Definition
|
|
Term
| Where is the highest abundance of Neurofibrillary Tangles found? |
|
Definition
|
|
Term
| What Chromosomes are the 3 genes that Early onset Alzheimer's are associated with? |
|
Definition
|
|
Term
| What Proteins are associated with Early onset Alzheimer's? |
|
Definition
Amyloid Precursor Protein (APP)
Presenilin 1
Presenilin 2 |
|
|
Term
| What are the characteristics of Early onset Alzheimer's? |
|
Definition
Autosomal Dominant
Begins before age 65
Progresses more rapidly
5-10% of Alzheimer's patients |
|
|
Term
| What chromosomes are the 3 risk factor genes of Late onset, sporadic, Alzheimer's? |
|
Definition
|
|
Term
| What chromosome encodes Apolipoprotein E4? |
|
Definition
|
|
Term
| What protein participates in cholesterol transport, and is a risk factor for Alzheimer's? |
|
Definition
Apolipoprotein E4
(contributes to 50% of late onset AD) |
|
|
Term
| Based on the Kaplan-Meier curve, by what age are people that have homozygosity for ApoE4 assured to develop AD? |
|
Definition
|
|
Term
| What genotype is 2nd most likely to develop AD? |
|
Definition
|
|
Term
| What genotype is least likely to develop AD? |
|
Definition
|
|
Term
| What are the Strong Risk factors for Alzheimer's Disease? |
|
Definition
|
|
Term
| What are Weak Risk factors for Alzheimer's Disease? |
|
Definition
Education level, mental inactivity
Female gender
Head injury
Hypercholesterolemia
Smoking |
|
|
Term
| What nucleus is noted to become atrophic in Alzheimer's patients? |
|
Definition
nucleus basalis
(nucleus of Meynert) |
|
|
Term
| What does the Nucleus Basalis innervate? With what? |
|
Definition
|
|
Term
| Where are levels of Ach found to be decreased in AD patients? |
|
Definition
| Nucleus Basalis and Neocortex |
|
|
Term
| What type of drugs can be used to increase neuronal activity in the neocortex? |
|
Definition
AchE antagonists
BuchE antagonists |
|
|
Term
| What do astrocytes secrete that cleaves Ach? |
|
Definition
|
|
Term
|
Definition
eosinophilic Spherical inclusions w/ halo appearance located in the cytoplasm of neurons
Parkinson's Disease - substantia negra
Lewy Body Dementia - neocortex |
|
|
Term
| What are Lewy Bodies comprised of? |
|
Definition
Neurofilament proteins
a-synuclein
ubiquitin |
|
|
Term
| What is Dementia with Lewy Bodies? |
|
Definition
Clinical characteristics of Parkinson's Disease with...
Early Presenting Dementia -
hallucinations
delusions
cognitive fluctuations |
|
|
Term
| Where are Lewy bodies found in DLB patients? |
|
Definition
|
|
Term
| Why should neuroleptic agents be avoided in DLB patients? |
|
Definition
| DLB patients are extremely sensitive to them |
|
|
Term
| What Dementia is characterized by atrophy of the frontal and temporal lobes? |
|
Definition
| Fronto-temporal Dementias |
|
|
Term
| What is the hallmark pathological feature of Fronto-temporal Dementias? |
|
Definition
Neurofibrillary tangles
Pick Bodies - ubiquitin and hyper-phosphorylated Tau proteins |
|
|
Term
| What form of Dementia has prominent personality and behavioral changes, with less memory loss early in the course? |
|
Definition
| Fronto-Temporal Dementias |
|
|
Term
| What are some common behavior and conduct distrubances found in FTD? |
|
Definition
loss of personal awareness
Loss of social comportment
disinhibition
impulsivity
distractibility
hype-orality
social withdrawal
stereotyped or preservative behavior
speech output change |
|
|
Term
| What type of Dementia displays early prominent primitive or frontal reflexes on physical exam? |
|
Definition
| Fronto-temporal Dementias |
|
|
Term
| What are the 4 Diseases included in Fronto-temporal Dementias? |
|
Definition
Pick's disease w/ or w/o Pick's bodies
FTD w/ Parkinsonism
Corticobasal Ganglionic Degeneration
Progressive Supranuclear Palsy |
|
|
Term
| What are the 3 principal varieties of Fronto-temporal Dementias? |
|
Definition
Frontal Variant FTD
Semantic Dementia
Progresive non-fluent aphasia |
|
|
Term
| Why is FTD commonly misdiagnosed if semantic dementia and progressive non-fluent aphasia are present, frontal variant is not? |
|
Definition
| these subtypes do not have prominent behavioral or personality dixturbance like the frontal variant FTD |
|
|
Term
| What is the age of onset for Pick's Disease? |
|
Definition
|
|
Term
| What is the mutation that is found in the familial cases of Pick's Disease? |
|
Definition
| on chromosome 17 for Tau protein |
|
|
Term
| What are the characteristics of Pick's Disease? |
|
Definition
Progressive loss of language and judgment w/ disinhibition, social misconduct, or withdrawal
Without anterograde amnesia |
|
|
Term
| What lobe is primarly involved in Pick's disease if there is an early loss of receptive language? |
|
Definition
|
|
Term
| What symptoms are associated with Frontal Lobe Involvement? |
|
Definition
Disinhibited, socially inappropriate
Impulsive
Compulsive
Hyperphagic/Oral
Hypo/Hypersexual
Non-fluent aphasia |
|
|
Term
| What symptoms are associated with Temporal Lobe Involvement? |
|
Definition
Fluent (semantic) aphasia
Emotionally flat, apathetic |
|
|
Term
| What is the 2nd most common cause of Dementia? |
|
Definition
|
|
Term
| What form of Dementia is caused by multiple infarctions involving either or both large vessels and small vessels? |
|
Definition
|
|
Term
| What are cases of Vascular Dementia typically found in? |
|
Definition
Diabetes mellitus
hypertension
coronary heart disease
peripheral artery disease |
|
|
Term
| What type of dementia has a high incidence in untreated or poorly treated hypertension? |
|
Definition
|
|
Term
| What Folstein Mini-Mental status exam score should raise concern of imparied cognition, depression or both? |
|
Definition
|
|
