CMN 577 Unit 2-2024
In performing the PE on a patient with a neurological complaint, what is important to take note of? -
CORRECT ANS-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 ANS-B12 deficiency, infection,
polypharmacy, alcohol/drug abuse
What may be psychosocial factors in altered mental status? -CORRECT ANS-Depression, Anxiety, Grief, ?
Elder Abuse
STM loss is associated with? -CORRECT ANS-B12 deficiency and Hypothyroidism
What diagnostic tests should be performed in AMS? -CORRECT ANS-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 ANS-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 ANS-Delirious
Some acute mental status changes noted in delirium include? -CORRECT ANS-Confusion, hallucinations,
restlessness, and incoherent speech
Onset of dementia is gradual and progressive, and usually occurs after age ?? -CORRECT ANS-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 ANS-Pick's Disease
,What is the first noticeable difference between Pick Disease and Alzheimer's? -CORRECT ANS-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 ANS-Lewy Body Dementia
Lewy body dementia and Parkinson's disease can result in? -CORRECT ANS-Rigid muscles, slowed
movements, and tremors
In Lewy body dementia, protein deposits develop in nerve cells in regions of the brain involved in? -
CORRECT ANS-Thinking, memory, and movement
What diagnostic tests are appropriate for Alzheimer's diagnosis? -CORRECT ANS-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 ANS-Axona
What are the treatment options for Alzheimer's Disease? -CORRECT ANS-Cholinesterase Inhibitors
(memantine (Namenda)) and antidepressants, diet and exercise
What tests are helpful in evaluating/diagnosing Dementia? -CORRECT ANS-MMSE (not used anymore),
MoCa, SLUMS, and Mini-Cog
The Mini-Cog should be used for initial testing. If (+), then move on to? -CORRECT ANS-MoCa or SLUMS
What is NPH? -CORRECT ANS-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 ANS-Gait changes, Altered thought processes, and
urinary incontinence
What is the treatment of NPH? -CORRECT ANS-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 ANS-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 ANS-4.5
What medications are indicated for post-stroke treatment? -CORRECT ANS-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 ANS-Pradaxa, Xarelto, Eliquis
What is the typical age of onset for Parkinson's disease? -CORRECT ANS-45-65
What are the symptoms of Parkinson's? -CORRECT ANS-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 ANS-Huntington's Chorea and Wilson's disease
What is Huntington's Chorea? -CORRECT ANS-Inherited disease with progressive dementia, bizarre
movements, and posture
What is Wilson's disease? -CORRECT ANS-Accumulation of copper in various vital organs
In performing the PE on a patient with a neurological complaint, what is important to take note of? -
CORRECT ANS-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 ANS-B12 deficiency, infection,
polypharmacy, alcohol/drug abuse
What may be psychosocial factors in altered mental status? -CORRECT ANS-Depression, Anxiety, Grief, ?
Elder Abuse
STM loss is associated with? -CORRECT ANS-B12 deficiency and Hypothyroidism
What diagnostic tests should be performed in AMS? -CORRECT ANS-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 ANS-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 ANS-Delirious
Some acute mental status changes noted in delirium include? -CORRECT ANS-Confusion, hallucinations,
restlessness, and incoherent speech
Onset of dementia is gradual and progressive, and usually occurs after age ?? -CORRECT ANS-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 ANS-Pick's Disease
,What is the first noticeable difference between Pick Disease and Alzheimer's? -CORRECT ANS-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 ANS-Lewy Body Dementia
Lewy body dementia and Parkinson's disease can result in? -CORRECT ANS-Rigid muscles, slowed
movements, and tremors
In Lewy body dementia, protein deposits develop in nerve cells in regions of the brain involved in? -
CORRECT ANS-Thinking, memory, and movement
What diagnostic tests are appropriate for Alzheimer's diagnosis? -CORRECT ANS-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 ANS-Axona
What are the treatment options for Alzheimer's Disease? -CORRECT ANS-Cholinesterase Inhibitors
(memantine (Namenda)) and antidepressants, diet and exercise
What tests are helpful in evaluating/diagnosing Dementia? -CORRECT ANS-MMSE (not used anymore),
MoCa, SLUMS, and Mini-Cog
The Mini-Cog should be used for initial testing. If (+), then move on to? -CORRECT ANS-MoCa or SLUMS
What is NPH? -CORRECT ANS-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 ANS-Gait changes, Altered thought processes, and
urinary incontinence
What is the treatment of NPH? -CORRECT ANS-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 ANS-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 ANS-4.5
What medications are indicated for post-stroke treatment? -CORRECT ANS-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 ANS-Pradaxa, Xarelto, Eliquis
What is the typical age of onset for Parkinson's disease? -CORRECT ANS-45-65
What are the symptoms of Parkinson's? -CORRECT ANS-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 ANS-Huntington's Chorea and Wilson's disease
What is Huntington's Chorea? -CORRECT ANS-Inherited disease with progressive dementia, bizarre
movements, and posture
What is Wilson's disease? -CORRECT ANS-Accumulation of copper in various vital organs
