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SI 6
Med 3
| Question | Answer |
|---|---|
| National adult reading test | premorbid intelligence |
| Wechsler adult intelligence scale revised | general intellectual functioning |
| Russel revision of Wechsler memory scale | memory |
| Reitan trailmaking test | visuospatial functioning (frontal lobe executive functioning) |
| wisconsin card sorting test | abstract problem solving (frontal lobe) |
| causes of dementia (A Vindicated PI) | anoxia, vascular, inflammotory/infection, neoplasia, degenerative, intoxication, congenital, allergic/autoimmune, trauma, endocrine, diet, psychiatric, iatrogenic |
| mini mental status examination | obvious history, older ppl, quite advanced deterioration |
| neuropsychological assessment | usuall reserved for younger patient, rule out pseudodementia, type of dementia etc |
| cognitive disorder | thiking and memory |
| dementia | acquired impairment of intellect, memory and personality, but without impairment of consciousness |
| diagnosis of dementia | memory impairment + at least one of cognitive disturbance, aphasia, apraxia, agnosia or disturbance in executive functioning. severe enuf to cause occupational/social impairment. progressively worsening. not caused by others |
| echolalia, palilalia | echoing what is heard, repeating sounds/words over and over |
| apraxia | impaired ability to execute motor activities despite intact motor abilities, sensory function and comprehension of the task |
| agnosia | failure to recognize/identify objects despite intact sensory function |
| clinical tests for dementia | blood screen, ESR, urea, electrolytes, serum proteins, liver function tests, serological tests for syphilis, CXR, CT/MRI |
| common causes for dementia | Alzheimer's disease, vascular dementia (eg. multi-infarct dementia), alcohol |
| multi-infarct dementia | multiple bilateral supratentorial infarcts, multifocal decrease in CBF (eg. thalamus, basal ganglia), urinary disturbances later on. |
| CJD | PrP --> PrPSc, < 2 yrs, personality alterations, sleep disturbances, myoclonic jerks etc. histology triad: neuronal loss, astrocytic proliferation, spongiform changes (microcystic cavitation) |
| meningioma | benign tumour of the meninges, derived from the arachnoid granulations |
| Alzheimer's disease | generalised and symmetrical atrophy, most marked in temporal, parietal and frontal lobes. Gyri thinned, sulci widened, ventricles dilated. Commonly die of bronchopneumonia |
| histology of AD | neurofibrillary tangles (paired helical filaments, aggregates of abnormally phosphorylated tau protein - microtubule for axonal transport), senile (neuritic) plaque (central core of amyloid protein, aggregates of dilated tortuos neurites) |
| treatment delirium tremens | benzodiazepines eg. diazepam, which enhance binding of GABA to the receptors |
| advanced directives | 1. possibility of changes in the person, 2.problem of foreseeing in which specific circumstances he wishes to prevent treatment, 3. origins of the statement, freely made? others involved? |
| substituted judgements | different responses of patient to bad news etc |
| best interest judegments | best interest itself is contestible, sometimes foolish decision by patient |
| hashimoto's thyroiditis | elevated cholesterol and triglyceride, autoantibodies (thyroglobulin/microsomal - enzyme peroxidase), myxoedema (accumulation of water + mucopolysaccharide) |
| some normal CT scan for elderly | calcified pineal gland, choroid plexus |
| Wernicke's encephalopathy | triad only present in 16%: confusion, ataxia, eye changes (eg. nystagmus, paralysis); acute thiamine (B1) deficiency |
| Korsakoff's psychosis (1) | damage to the diencephalic structures including the mammillary bodies and the dorsolateral nucleus of thalamus. Severe anterograde amnesia, a gradient of retrograde amnesia, but intact sensory and working memory as well as procedural learning |
| thiamine | 6 weeks, precipitated with glucose load |
| alcoholic polyneuritis | symmetrical damage of LMN, distal limbs more affected, hyperalgesia |
| max safe limits for alcohol consumption | M: 21 units/wk 6 units/session; F: 14, 4 |
| Korsakoff's psychosis (2) | amnesia, confabulation, peripheral neuropathy, clear consciousness and other intellectual functioning |
| one standard drink | ~10g |
| GFAP | glial fibrillary acidic protein, intermediate filament found in the cytoplasm of astroctyes |
| acute complications of alcohol | uncomplicated withdrawal (1-5 days after, seizures etc), delirium tremens |
Created by:
tioin355