Exam (elaborations)
CMN 577 Unit 2.
Exam of 19 pages for the course ACO CORB. at ACO CORB. (CMN 577 Unit 2.)
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CMN 577 Unit 2In performing the PE on a patient with a neurological complaint, what is important
to take note of? - CORRECT ANSWER-General appearance and affect,
Establish mental status, Oberve motor function/gain, Consider cranial nerves,
reflexes, fundoscopic and sensory exam
10-20% of treatable causes of altered mental status include? - CORRECT
ANSWER-B12 deficiency, infection, polypharmacy, alcohol/drug abuse
What may be psychosocial factors in altered mental status? - CORRECT
ANSWER-Depression, Anxiety, Grief, ? Elder Abuse
STM loss is associated with? - CORRECT ANSWER-B12 deficiency and
Hypothyroidism
What diagnostic tests should be performed in AMS? - CORRECT ANSWER-UA,
CBC, BMP, B12, RPR, ESR, and TSH——- Further tests dependent upon
complaints/symptoms
What test is the gold standard for a dementia work-up and is often useful for
ruling out stroke, masses, etc...? - CORRECT ANSWER-Head CT Scan
Rhonda is a 68 y.o woman who has started having problems remembering things
in the last few days (like where she put her keys). She comes to your clinic and
you test a UA and see she has a raging UTI and fever. Is Rhonda demented or
delirious? - CORRECT ANSWER-Delirious
Some acute mental status changes noted in delirium include? - CORRECT
ANSWER-Confusion, hallucinations, restlessness, and incoherent speech
Onset of dementia is gradual and progressive, and usually occurs after age ?? -
CORRECT ANSWER-60
Gil is a 62 y.o Male coming into the clinic today (with his daughter) with
progressive loss of speech and memory problems, as well as angry outbursts.
,Upon investigation, Gil is found to have a build-up of Tau proteins in his neurons
that have accumulated into silver-staining, spherical aggregations. What is Gil's
diagnosis? - CORRECT ANSWER-Pick's Disease
What is the first noticeable difference between Pick Disease and Alzheimer's? -
CORRECT ANSWER-the personality change that hallmarks the onset of Pick's
disease versus the short term memory loss of Alzheimer's
Hillary has a recent diagnosis of dementia and comes into the clinic today with
her daughter. Hillary has been talking to her deceased sister around the house
and is increasingly drowsy. What type of dementia do you suspect? - CORRECT
ANSWER-Lewy Body Dementia
Lewy body dementia and Parkinson's disease can result in? - CORRECT
ANSWER-Rigid muscles, slowed movements, and tremors
In Lewy body dementia, protein deposits develop in nerve cells in regions of the
brain involved in? - CORRECT ANSWER-Thinking, memory, and movement
What diagnostic tests are appropriate for Alzheimer's diagnosis? - CORRECT
ANSWER-CBC, CMP, TSH, B12, RPR, CT Head
What is the name of the prescription medical food that is intended for the clinical
dietary management of the metabolic processes associated with mild to
moderate Alzheimer's disease? - CORRECT ANSWER-Axona
What are the treatment options for Alzheimer's Disease? - CORRECT
ANSWER-Cholinesterase Inhibitors (memantine (Namenda)) and
antidepressants, diet and exercise
What tests are helpful in evaluating/diagnosing Dementia? - CORRECT
ANSWER-MMSE (not used anymore), MoCa, SLUMS, and Mini-Cog
The Mini-Cog should be used for initial testing. If (+), then move on to? -
CORRECT ANSWER-MoCa or SLUMS
, What is NPH? - CORRECT ANSWER-Normal Pressure Hydrocephalus- It is an
enlargement of the ventricles WITHOUT increased ICP- presents in >/= 60 y.o
What is the triad of symptoms in NPH? - CORRECT ANSWER-Gait changes,
Altered thought processes, and urinary incontinence
What is the treatment of NPH? - CORRECT ANSWER-Treatment of
symptoms-anticholinesterase inhibitors may be helpful w/ memory loss
Shunt placement- can be considered but must weigh pros and cons
What are some risk factors for stroke? - CORRECT ANSWER-HTN, DM, CAD,
Migraine Headaches, Hyperlipidemia, Tobacco Abuse, ETOH/drug abuse,
personal/family hx of stroke
Ischemic stroke treatment must be initiated within ??? Hours of onset. -
CORRECT ANSWER-4.5
What medications are indicated for post-stroke treatment? - CORRECT
ANSWER-Anti-coagulant therapy (may include ASA, Plavix, Aggrenox,
Coumadin)
If atrial fibrillation is the underlying cause of the CVA, what anticoagulants may be
considered? - CORRECT ANSWER-Pradaxa, Xarelto, Eliquis
What is the typical age of onset for Parkinson's disease? - CORRECT
ANSWER-45-65
What are the symptoms of Parkinson's? - CORRECT ANSWER-Tremor, rigidity,
bradykinesia, and postural instability- considered "hallmark" features
First symptom is usually "pill-rolling" tremor unilaterally, that is absent during
sleep, with maximum SXS at rest
If a patient has SXS of Parkinson's, but are younger than 50, what two diseases
must be ruled out? - CORRECT ANSWER-Huntington's Chorea and Wilson's
disease
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