Are these statements TRUE or FALSE?
Though the links to the relevant articles are provided, you DON’T have to re-read that article. Correct answers are given in just few sentences.
1. The diagnosis of Neurocognitive Disorders with Lewy Bodies (Dementia with Lewy Bodies) is suggested by the appearance of parkinsonism months or even years before the appearance of clear cognitive decline.
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Answer: False
Explanation: There are two Lewy Body Dementias in both of which patients develop parkinsonism and cognitive decline. The difference between Dementia with Lewy Bodies (DLB, known in DSM-5 as Neurocognitive Disorder with Lewy Bodies) and Parkinson’s Disease Dementia (PDD, known in DSM-5 as Neurocognitive Disorder due to Parkinson’s Disease) is based on the course of illness. The difference between the two is somewhat arbitrary. But, according to DSM-5, in Neurocognitive disorder due to Parkinson’s disease, the Parkinson’s disease appears first and at least one year passes before the cognitive decline is of such severity that major neurocognitive disorder (dementia) can be diagnosed. Based on common sense, we can see how in such a situation one might think that the Parkinson’s disease is the cause of the neurocognitive disorder. On the other hand, in Neurocognitive disorder with Lewy bodies, the parkinsonian symptoms appear after the cognitive symptoms or around the same time.
Review: What is Lewy body dementia?
2. A drop in systolic blood pressure of 20 mmHg or more from lying to standing position occurring within 3 minutes indicates orthostatic hypotension.
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Answer: True
Explanation: A drop in systolic blood pressure of 20 mmHg or more and/or a drop in diastolic blood pressure of 10 mmHg or more from lying to standing position occurring within 3 minutes has been the standard, accepted definition of orthostatic hypotension for many years. A drop in systolic blood pressure of 20 mmHg or more has been shown to correlate with falls (Shibao et al., 2013).
3. If the serum prolactin is significantly high (e.g., greater than 200 ng/mL) in a patient being treated with an antipsychotic, a reasonable first step is to try adding aripiprazole.
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Answer: False
Explanation: If the serum prolactin is significantly high (e.g., greater than 200 ng/mL) and/or the person has persistent headaches or visual disturbances, we should refer the person to a specialist for diagnostic imaging of the sella turcica to look for a pituitary adenoma. This is very important to remember.
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