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medicine year 1 and 2 > case 22 > Flashcards

case 22 Flashcards

1
Q

what are 3 lewy body diseases?

A
  • parkinson’s
  • parkinson’s dementia
  • dementia with lewy bodies
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2
Q

what is the dementia definition according to the WHO?

A

a syndrome in which there isdeterioration in memory, thinking, behaviour and the ability to perform everyday activities.

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3
Q

what is the diagnostic criteria for dementia written by NICE?

A

patient must have impairment in at leasttwo cognitive domains
(memory, language, behaviour, and visuospatial or executive function) leading tosignificant functional decline (enough to affect ADLs) thatcannot be explained by another disorder or adverse effects of medication.

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4
Q

what are the 4 most common types of dementia in order?

A

1) Alzheimer’s (>50%)
2) vascular
3) mixed
4) DLB

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5
Q

what is the prognosis of DLB?

A

average survival rate=5-8 years from onset

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6
Q

what are the 2 most common dementias in people under 65?

A

1) early onset alzheimer’s

2) fronto-temporal demenia

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7
Q

what is CJD caused by?

A

prions

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8
Q

what is confabulation?

A

the production of fabricated or misenterpreted memories. can range from subtle altercations to bizarre fabrications.

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9
Q

what happens in korsakoff’s dementia and what causes it?

A

severe memory disturbance with confabulation to compensate.
caused by severe B1 deficiency (thiamine) classically associated w alcohol dependency but also malabsorption and malnutrition.
also can be b12 deficiency

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10
Q

what are the features of the initial dementia/confusion screen?

A

history
cognitive assessment
bloods
imaging

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11
Q

what imaging do they use in the initial cognitive assessment?

A

1st line: CT/NRI

2nd line: SPECT/PET if diagnostic uncertainty.

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12
Q

what happens in atypical alzheimer’s?

A

memory problems aren’t the first symptom.

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13
Q

how can medial temporal lobe atrophy be assessed?

A

on imaging using the MTA score

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14
Q

in DLB what does the dementia mainly affect?

A

attention and executive function (planning/organising)

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15
Q

how does bradykinesia typically present?

A

hypomimia (reduction of facial expression)
monotonous/slurred speech
reduced blink rate
generalised motor slowness

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16
Q

what are some of the potential surgical treatments for parkinson’s?

A 
ablative surgery (removing/reprogramming brain tissue) 
deep brain stimulation 
striatal grafts 
infusion of neurotropic factors 
gene therapy
17
Q

what does neurotropic mean?

A

having an affinity for nerve cells

18
Q

which circuit is abnormal in parkinson’s?

A

motor basal ganglia circuit

19
Q

in deep brain stimulation for parkinson’s, which structures do you apply stimulation to?

A 
subthalamic nucleus, globus pallidus interna, 
pedunculopontine nucleus (PPN)
20
Q

how is huntington’s inherited?

A

autosomal dominant

21
Q

what is the genetic cause of huntington’s?

A

short arm of chromosome 4

expanded CAG repeat sequence

22
Q

what are some examples of misfolded proteins that cause neurodegenerative diseases?

A

hyperphosporylated tau (HPt)
amyloid beta (Ab)
alpha-synuclein (a-syn)
huntington protein

23
Q

how many items can we store in working memory?

A

5-9, as long as we keep repeating them

24
Q

what is the sulcus terminalis?

A

v shaped groove separating the oral and pharyngeal parts of the tongue

25
Q

what are neurofibrillary tangles (NFTs) ?

A

aggregates of hyperphosphorylated tau protein

26
Q

what does the nucleus ambiguus contain?

A

cell bodies of nerves that innervate the soft palate, pharynx and larynx.
(common nucleus for efferent fibres of CNIX and CNX)

27
Q

Which technique would be used to measure cerebral blood flow using gamma radiation?

A

SPECT-orange for hyperperfusion, purple for hypoperfusion

28
Q

what is the 4-AT?

A

tool used to screen for delirium

29
Q

what is the UK’s tool for assessing cognition?

A

ACE-III (adenbrook’s cognitive evaluation)

30
Q

what is the typical triad of symptoms seen in neuroleptic malignant syndrome?

A

fever
muscle rigidity
altered mental state

medicine year 1 and 2 (29 decks)

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