Alzheimer's Disease - 236

Question 1

Give at least 2 points from the ICD-10 diagnostic criteria for Alzheimer’s disease

Answer 1

1) Acquired impairment in memory for at least 6 months 
Plus at least 1 more of:
2) impaired executive functioning
3) impaired language
4) impaired praxis
5) impaired gnosis

Question 2

What is praxis? Gnosis?

Answer 2

Praxis = learned motor tasks
Gnosis = ability to recognise objects, faces, sensory info

Question 3

What % of over 80s have dementia?

Answer 3

20%

Question 4

What is the most common, and 2nd most common types of dementia?

Answer 4

Alzheimer's = 1st
Vascular = 2nd

Question 5

Give 4 differentials for dementia

Answer 5

Depression, underlying physical illness, mild cognitive impairment, delerium

Question 6

Describe how the presentations of AD and VD differ

Answer 6

AD: gradual deterioration. Loss of insight
VD: sudden onset with stepwise deterioration, mood and behavioural changes and preserved insight.

Question 7

Describe the neuropathology of AD

Answer 7

Amyloid plaques, neurofibrillary tangles. Deficit in cholinergic neurotransmission

Question 8

Give 3 risk factors for AD and for VD

Answer 8

AD: increasing age, female, genetics, head injury, Down’s
VD: smoking, diabetes, high cholesterol, high bp, male

Question 9

What is Pick’s disease and how might patients present?

Answer 9

Fronto-temporal dementia.
Patients are apathetic, reduced motivation, self neglect, disinhibited, decreased social awareness, changes in personality

Question 10

What drug is used to treat moderate/severe AD or Lewy body dementia? What kind of drug is it?

Answer 10

Memantine, NMDA antagonist

Question 11

What drug is used for mild AD or lewy body dementia? What kind of drug is it?

Answer 11

Donepezil, rivastigmine, galantamine. Anti-cholinesterase inhibitor.

Question 12

What does each area of the brain provide information on regarding memory? Occipital, parietal, temporal and frontal

Answer 12

Occipital - visual cortex
Parietal - ‘where is it’
Temporal - ‘what is it’
Frontal - select, plan, response

Question 13

What would inferior temporal cortex damage result in?

Answer 13

Visual agnosia (can see something but not identify it)

Question 14

What would fusiform gyrus damage result in?

Answer 14

Prosopagnosia - can’t recognise individuals from their faces

Question 15

Damage to the middle temporal cortex would result in what?

Answer 15

Movement agnosia, where you can’t tell if you are moving or stationary

Question 16

Damage to the frontal cortex would result in the loss of what?

Answer 16

Restraint, initiative and order

Question 17

Where is Broca’s area?

Answer 17

Frontal lobe

Question 18

What is Broca’s area responsible for?

Answer 18

Making speech

Question 19

Where is Wernicke’s area?

Answer 19

Temporal lobe

Question 20

What is Wernicke’s area responsible for?

Answer 20

Understanding speech

Question 21

If someone has Broca’s aphasia what can they not do?

Answer 21

Cannot construct language but can understand it. Language is repetitive, syntax is disordered.

Question 22

If someone has Wernicke’s aphasia what can they not do?

Answer 22

Unable to understand language. Fluent speech that doesn’t make sense! Syntax is fine