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Geriatrics
Cognitive and Behavioral Disorders in the Geriatrics
| Question | Answer |
|---|---|
| Is Dementia part of the normal aging process? | * no |
| Diagnostic criteria of Dementia ? | *Impairment of Memory and one of the following severe enough to interfere with daily functioning: -Aphasia -Apraxia -Agnosia -Impaired executive function |
| Alzheimer’s Disease patho ? | * Extracellular deposition of amyloid-beta protein producing neuritic plaques ----*Development of neurofibrillary tangles----* narrow gyri and widened sulci |
| At least two physiological impairments may contribute to AD ? | * reduced cerebral production of acetylcholine transferase....* Excessive NMDA receptor stimulation |
| Alzheimer’s Treatment ? | *Cholinesterase Inhibitors - to keep ACh ....* NMDA Receptor Antagonists...* Vit. E |
| Alzheimer’s Disease-Diagnosis ? | * no confirmatory test besides brain biopsy after death.... * DSM-IV Diagnostic Criteria: -Impairment of recent memory -Gradual onset and continued decline of cognitive ability ..At least one of the following: -Aphasia -Apraxia -Agnosia |
| Best test for Alz ? | * Slums test...not mmse |
| Dementia with Lewy Bodies (DLB)Dx Criteria ? | * you see Lewy Bodies.... * Dx = Dementia criteria, Plus At least two of the following three clinical features: -Cognitive fluctuations -Visual hallucinations -Parkinsonism (Dementia preceding motor symptoms) |
| Good Dx tool ? | * mini mental cog status test...tests cognitive issues, not memory |
| DLB Tmt ? | *Nonpharmacological therapy is first choice...* cholinesterase inhibitors , atypical psychotics, and levodopa |
| Vascular Dementia how to Dx ? | * imaging (CT/MRI)...* vascular issues |
| Vascular Dementia Tmt ? | * control vascular risk factors |
| Parkinson’s Disease with Dementia (PDD)criteria ? | * criteria states that with PDD, the motor symptoms occur at least 1 year prior to the cognitive symptoms |
| Tmt of PDD ? | * cholinesterase inhibitors |
| Frontotemporal Dementia basics ? | * Characterized by focal atrophy of the frontal and temporal lobes.......* Progresses more rapidly than AD, onset to death is 8.7 years versus 11.8 years in AD |
| Reversible Dementia (Delirium) basics ? | * meds induced, alcohol, metabolic disorders, depression, etc. |
| Top Diagnosis tool? | * history |
| Mini Mental Status Exam scores ? | * 26-30 is normal ....20-25 mild deficit ....10-19 moderate deficit ....<10 severe deficit |
| Depression masquerading as Dementia ? | * History of becoming lost and disoriented, w/ a history of depressed mood.......So ask if they are ever depressed or feel sad.....* antidepressive drugs have been shown to bring them out of depression, which brings them out of their dementia state |
Created by:
thamrick800
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