Alzheimer's and other dementias Flashcards
Definition of dementia
Progressive deficits in several cognitive domains
How does dementia usually present?
Progressive memory loss over months to years
Important aspects of history in suspected dementia (6)
Timeline of deficits Particular aspects of deficit e.g. memory Activities of daily living Finances Medication Other symptoms
Other symptoms of dementia (4)
Mood disturbance
Apathy
Wandering
Agitation/aggression
Tests to exclude a reversible cause (6)
FBC, U&Es, calcium, LFTs, glucose, TSH
Imaging modalities in dementia (3)
CT
MRI
Functional imaging e.g. PET, SPECT
Pathophysiology of AD (2)
Beta-amyloid plaques and tau neurofibrillary tangles
Acetylcholinergic neuronal loss
Areas where neurones are particularly lost in AD (4)
Nucleus basalis of Meynert
Temporal lobe
Amygdala
Hippocampus
Risk factors for AD (4)
1st degree relative affected
Downs syndrome
Vascular risk factors
APOE e4 allele
Pharmacological management of AD (2)
AChesterase inhibitors
Antiglutamergics e.g. memantine
Examples of AChesterase inhibtors (3)
Rivastigmine
Donepezil
Galanatime
Features suggesting vascular dementia rather than AD (2)
Stepwise deterioration
Various vascular risk factors/events
Features of Lewy body dementia (3)
Fluctuating cognitive impairment
Detailed visual hallucinations
Parkinsonism
What are Lewy bodies?
Cytoplasmic inclusions of alpha-synuclein
What drugs should be avoided in Lewy body dementia?
Neuroleptics e.g. haloperidol- may cause irreversible parkinsonism
