Alzheimer's Flashcards

1
Q

what is DSM-V used for

A

diagnosis of major neurocognitive disorders
must show significant decline from previous level of performance in 1 or more cognitive domains

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2
Q

what is tested in DSM-V

A

attention
executive function
memory
language
perceptual motor
social cognition

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3
Q

what aids in localisation of cognitive symptoms

A

memory - short/long term
attention/concentration
language - expressive/receptive
visuospatial
behavioural problems/change in personality

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4
Q

describe amyotrophic lateral sclerosis

A

found in motor cortex, brainstem and spinal cord
causes atrophy of motor neurons and muscles
bunina bodies and lewy body-like inclusions

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5
Q

describe Alzheimer’s disease

A

varies with Braak stage - entorhinal, hippocampus, parietotemporal cortex
causes cerebral atrophy
a-beta plaques and tangles

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6
Q

describe multiple sclerosis

A

found in CNS, brainstem and spinal cord
causes damage of myelin sheath and neurons
focal demyelinated plaques

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7
Q

describe Parkinson’s

A

found in midbrain and basal ganglia
causes pallor of substantia nigra
causes Lewy bodies

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8
Q

describe Lewy body dementia

A

found in cerebral cortex, hippocampus and brainstem
causes pallor of substantia nigra
causes cerebral atrophy and Lewy bodies

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9
Q

describe functional impairment in dementia

A

associated impairment in social/occupational functioning
deficits in managing finances, driving, shopping, working, taking medications, keeping appointments
eventual problems with activities of daily living
rate and specific pattern of loss will vary by individual and somewhat by diagnosis

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10
Q

describe the onset of Alzheimer’s

A

gradual onset and progression affecting cognition, personality, behaviours and ADLs

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11
Q

what are the characteristics of Alzheimer’s

A

deficits in short-term memory ( rapid forgetting of new material), language, praxis, visuospatial, executive

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12
Q

what is the duration of Alzheimers

A

5-15 years

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13
Q

what are the symptoms of Alzheimers

A

gradual and steady decline
anosognosia (lack of recognition of disease)
depression in 1/3
delusions and hallucinations in 1/3

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14
Q

pathophysiology of Alzheimers

A

neuritic plaques (extracellular, abnormal insoluble amyloid protein)
neurofibrillary tangles (intracellular, disturbed tau-microtubule complexes, hyperphosphorylated tau)
cholinergic system degeneration with significant loss of neurons in certain areas (often begins in entorhinal cortex and progresses to other limbic structures)

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15
Q

what are the cognitive assessments used for alzheimers

A

structured multi-domain tests - ACE-III, MoCA, ECAS, MMSE, cantab mobile
domain-specific tests - verbal/category fluency, clock drawing, immediate recall

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16
Q

how are lesions imaged in Alzheimers

A

structural imaging - MRI, finds volume and white matter tractography
functional imaging - FP-CIT SPECT, F-FDG PET, HMPAO SPECT
neuropsychology
CSF biomarkers - beta-amyloid, total tau, phospho-tau, alpha synuclein
genetics

17
Q

features of early Alzheimers

A

2-3 years after diagnosis
primarily memory and visuospatial defects
mild difficulty with executive functioning

18
Q

features of moderately severe Alzheimers

A

3-6 years after diagnosis
aphasia and apraxia
increased assistance with ADLs
neurophysiological symptoms, particularly paranoia

19
Q

features of advanced Alzheimers

A

6-12 years after diagnosis
language disturbances (mutism, echolalia, repetitive vocalisations)
agitation, aggression
rigidity, gait distrubances
incontinence
swallowing problems
death

20
Q

management of Alzheimers

A

detect, assess, differentiate, diagnose, treat and monitor