9- Dementia And Delirium Flashcards
What are cognitive symptoms associated with dementia?
Impaired memory, orientation, learning capacity and judgment
What are some non-cognitive features of dementia?
Behavioural symptoms (agitation, aggression), depression/anxiety, psychotic features (hallucinations, delusions), sleep symptoms
What conditions other than dementia can cause cognitive decline, and should be ruled out before diagnosis of dementia?
Hypothyroidism, hypercalcaemia, B12 deficiency, hydrocephalus
What are the different types of dementia?
Alzheimer’s, vascular, lewy body, frontal-temporal, AIDS dementia complex
What are the macroscopic pathological features found in Alzheimer’s?
Global cortical atrophy, sulcan widening and enlarged ventricles
What are some microscopic pathological changes found in Alzheimer’s?
Amyloid plaques (amyloid beta) and neurofibrillary tangles (hyperphosphorylated tau protein)
What are some risk factors of vascular dementia?
Previous vascular events, hypertension, high cholesterol, diabetes, smoking
Which disease in Lewy body dementia essentially the same as?
Parkinson’s disease
What are Lewy bodies composed of?
Alpha-synuclein
In Lewy body dementia where can the main deposits be found across the brain?
Substantia nigra, temporal lobe, frontal lobe, cingulate gyrus (found just above the corpus callosum)
How may a patient with Lewy body dementia present?
Fluctuating congnitive state, vivid visual hallucinations, parkinsonian features
What psychiatric emergency can occur if you give anti-psychotics to a patient with Lewy body dementia?
Neuroleptic malignant syndrome
What is the peak age of onset for frontal-temporal dementia?
Mid 50s
What symptoms are associated with frontal-temporal dementia?
Inappropriate behaviour, loss of motivation without depression, repetitive behaviours, non fluent (Broca) aphasia
What is the basic pathophysiology of AIDS dementia complex?
HIV infected macrophages enter the brain and lead to indirect damage to neurones
What it the progression like in AIDS dementia complex?
Rapid progression
Where in the brain can have involvement in AID dementia complex not seen usually in other forms of dementia?
Cerebellum
What are examples of cholinesterase inhibitors?
Donepezil, rivastigmine, galantamine
what drugs can be used in the treatment of dementia?
Acetylcholinesterase inhibitors in mild-moderate forms NMDA antagonists (memantine) in moderate-severe forms
Which of dementia or delirium is reversible?
Delirium- reversible
Dementia- irreversible
What types of delirium are there?
Hypoactive, hyperactive and mixed
How will someone with hypoactive delirium act?
Withdrawn, quiet, sleepy
How will someone will hyperactive delirium act?
Restless, agitated, aggressive
