Dementia and Delirium

bananas's version from 2015-05-25 20:17


Question Answer
Definition of DementiaDecrease in cognitive ability, memory with intact consciousness
Which areas of the brain are usually affected in dementia?Frontal cortex, Hippocampus
Most common cause of DementiaAlzheimer's
2nd Most common cause of DementiaVascular Dementia
Which chromosomal disorder is predisposed to developing Alzheimer's and why?Down's syndrome (Trisomy 21): APP gene is found on chromosome 21
Which proteins are altered in the familial form of Alzheimer'sAPOE4: Chaperones that induce formation of BEta sheets
Which mutation is associated with early onset Alzheimer'sPresenilin-1 and Presenilin-2: APP protein
Which protein is protective from Alzheimer's?ApoE2
Gross changes to the brain in Alzheimer'sDiffuse cortical atrophy
Narrowing of gyri
Widened sulci
What extracellular deposit is found in Alzheimer's?Senile/Amyloid plaques
What intracellular deposit is found in Alzheimer's?Neurofibrillary tangles and hyperphosphorylated tau protein
Which part of the brain is usually atrophied in Pick's disease and how does this affect the presentation?Frontal lobe: Crass and inappropriate behavior
Temporal lobe: Language aphasia
What unique symptoms are seen in Frontotemporal dementia?Aphasia and parkinsonian aspects
What is the triad of symptoms of Lewy Body dementia?1. Visual Hallucination
2. Syncope with falls
3. Parkinsonism
What is the defect in Lewy body dementia?α-synuclein defect of Lewy bodies in the Cortex
What is a key finding in Creutzfeldt Jacob disease?Myoclonus (Startle myoclonus)
What is the prognosis of Creutzfeldt JakobRapid progressive (weeks to months) -- death within 1 year
Etiology of Creutzfeldt Jakob1. Sporadic
2. Inherited3. Transmitted (Mad cow)
Gross changes to the brain with Creutzfeldt JakobSpongiform cortex
What is the mechanism of creutzfeldt Jakob?Prions cause beta pleated sheets that collect in the neurons, causing spongy holes
What is Vascular Dementia?Multifocal small infarcts
What is the triad for Normal hydrocephalus?Wet Wacky and Wobbly
Dementia work up1. RPR (Syphillis)
2. HIV
3. B12
4. TSH
5. MRI (Normal pressure hydrocephalus)
6. Slit lamp (Wilson)
Reversible causes of DementiaB12 deficiency, Hypothyroidism, Normal Pressure Hydrocephalus

Rapid Fire

Question Answer
Visual HallucinationsLewy Body Dementia
Progressive AphasiaFrontotemporal Dementia (Pick)
Ataxia and Loss of Pupillary Light ReflexTertiary Syphillis
Megaloblastic AnemiaB12
Resting Tremor and BradykinesiaLewy Body Dementia or Frontotemporal dementia Parkinson's
Uninhibited social behavior (crass)Frontotemporal Dementia (Pick)
Urinary incontinence and magnetic gaitNormal Pressure Hydrocephalus [Wet Wacky Wobbly]
Syncopal episodesLewy Body Dementia
Dysarthria and Liver DiseaseWilson
Weight gain, Hair loss, Dryness, ConstipationHypothyroidism
Aware of memory lossDepression
Rapid progression Creutzfeldt-Jakob and Lewy Body dementia
Atherosclerosis or HTNVascular dementia


Question Answer
Neurofibrillary tanglesAlzheimer's
Amyloid plaquesAlzheimer's
Hyperphosphorylated tau protein (extracellular)Alzheimer's
Pick bodiesFrontotemporal dementia (Pick dementia)
Spherical tau protein (intracellular)Frontotemporal dementia (Pick dementia)
Pick bodies: seen with Silver stain
PrP(prions) Creutzfeldt-Jakob


Question Answer
Onset of DeliriumAcute
Course of DeliriumWax and waning througout the day
Level of consciousnessDecreased, Decreased attention span and level of arousal
Disturbed Sleep-wake cycle
Thought productionHallucinations
Disorganized thinking
Flight of Ideas
Most common causes of Delirium1. Drugs: Benzo's, Anticholinergics
2. UTI
What physical finding will be present with DeliriumAbnormal EEG