Chapter 2 · Lubega Zarwango, RN, MSN

Dementia: Major Neurocognitive Disorders

15 practice questions built only from your chapter.

● Draft — pending approval by Lubega Zarwango

Most important points

Dementia = major neurocognitive disorder: acquired decline that interferes with independence, not explained by delirium or another mental disorder.
Cortical (Alzheimer, frontotemporal, Creutzfeldt-Jakob): amnesia, aphasia, apraxia, agnosia.
Subcortical (Huntington, Parkinson disease dementia, HIV-associated): slowed thinking, depression, irritability, apathy, motor signs.
Alzheimer: acetylcholine deficiency + diffuse atrophy (hippocampus/medial temporal); early exam shows no focal deficit.
Lewy body: visual hallucinations, fluctuations, REM sleep behavior disorder, parkinsonism — severe antipsychotic sensitivity.
One-year rule: dementia before or within 1 year of parkinsonism = dementia with Lewy bodies; more than 1 year after = Parkinson disease dementia.
Creutzfeldt-Jakob: rapid decline over weeks to months, myoclonus, cortical ribboning on diffusion MRI, positive RT-QuIC.
Mild vs major: not the score alone — whether the person can still live independently.
Avoid cholinesterase inhibitors in frontotemporal dementia — no benefit, may worsen behavior.

Question 1 · dementia

Which group lists the three classic CORTICAL dementias?

Question 2 · dementia

The two signature mechanisms of Alzheimer disease for examination purposes are:

Question 3 · dementia

A 58-year-old with new disinhibition, loss of empathy and a sudden preference for sweets, with memory relatively intact. Most likely diagnosis?

Question 4 · dementia

A patient with dementia, well-formed visual hallucinations and parkinsonism becomes agitated. Which medication is MOST important to avoid?

Question 5 · dementia

Dementia begins 3 years after established Parkinson disease. The diagnosis is:

Question 6 · dementia

Rapid decline over 8 weeks with startle myoclonus and cortical ribboning on diffusion-weighted MRI suggests:

Question 7 · dementia

In the systematic review of 1,701 patients with rapidly progressive dementia, the single most common cause was:

Question 8 · dementia

What separates mild from major neurocognitive disorder?

Question 9 · dementia

A person with known dementia suddenly worsens over two days with impaired attention. First assumption?

Question 10 · dementia

Which finding favors depression-related cognitive impairment (pseudodementia) over dementia?

Question 11 · dementia

Huntington disease is inherited how, and on which chromosome?

Question 12 · dementia

HIV-associated dementia: severe dementia typically occurs when CD4 count falls below:

Question 13 · dementia

Which drug class should be AVOIDED in frontotemporal dementia?

Question 14 · dementia

According to the 2024 Lancet Commission, how many modifiable risk factors account for about 45 percent of dementia?

Question 15 · dementia

Which screening tool is more sensitive for mild cognitive impairment?