Chronic Conditions 1.3 - Dementia Flashcards
What is the definition of dementia?
A cluster of symptoms caused. By loss of brain function
How is the diagnosis of dementia conducted?
Through the ruling out of reversible causes
Alzheimer’s disease
A progressive loss of cognitive function due to amyloid plaques and tau tangles
What causes vascular dementia
Caused by multiple strokes or diffuse infarctions with association of amyloid depositions in blood vessel walls (amyloidosis). This causes the blood vessels more brittle and prone to damage
Risk factors for developing dementia?
- genetics (family history)
- head injuries
- lack of education or cognitive stimulation
- trisomy 21
- cholesterol levels
- diabetes
What are amyloids?
Misfolded proteins that accumulate in the extracellular space
What are common deposition sites for amyloids?
- kidneys (nephrotic syndrome)
- heart (cardiomyopathies)
- bowel (chron’s)
How does amyloidosis have a specific association with Type 2 diabetes?
Amyloids are co-secreted w/ insulin and deposits in the islet of langerhans of the pancreas
What is the clinical implication of amyloidosis?
Amyloid cannot be removed once deposited in the Extracellular space
What chromosome does Alzheimer’s have a strong genetic link to
21
Why do most individuals with Down syndrome develop Alzheimer’s by the age of 40?
This is because they have trisomy 21 which as we know amyloid deposition have a propensity towards the receptors in chromosome 21
What are mimics of dementia?
- infectious
- nutritional deficiencies
- head trauma
- medication side effects
What are the complications of brain atrophy in dementia?
There is a increased risk of bridging vein rupture or subarachnoid hemorrhage from trauma
What medication can be used to treat dementia?
Cholinesterase inhibitors
What is the definition of Parkinson’s?
A progressive neurodegenerative movement disorder
What is the cause of Parkinson’s
Caused by a degeneration of dopaminergic neurons in the basal ganglia due to the disruption of the basal ganglia cortex feedback loop
Why do the symptoms of Parkinson’s arise?
Because of the decrease cortical stimulation and motor signal coordination
What is the definition of Huntington’s disease
A degenerative disease of the basal ganglia that affects the GABAergic neurons
What causes huntingtons?
Caused by a degeneration of GABAergic inhibitory neurons which leads to random muscle movements (chorea)
What symptoms in huntingtons occur in lates stages?
- gait instability or urinary incontinence
Which chromosome mutation can cause huntingtons?
Chromosome 4
What is the definition of systemic lupus erythematosus
A chronic systemic autoimmune disorder with relapsing and remitting flares
What is antigen-antibody complex formation with regard to SLE
Complexes that form when antibodies bind to antigens which are then deposited into tissues triggering inflammatory damage and complement activation
What is complement activation?
When complement proteins form a membrane attack complex to destroy perceived threats
What can trigger SLE?
- UV light exposure
- Stress
- Infection
What are the manifestations of SLE
-fatigue, fever and malaise
- malar rays across the nose and cheek
- raynauds
- MSK symptoms
- organ inflammation (Kidneys, Heart, Lungs)
What is the definition of Cellulitis?
Bacterial infection of skin and subcue tissue
Cellulitis is commonly cause by…
Staphylococcus aureus or group A strep
What are risk factors for Cellulitis?
- trauma
- surgical wounds
- neuropathy
How are neonates at risk for meningitis?
- group b strep or E. coli contamination
What is the definition of meningitis?
Inflammation of the leptomininges (arachnoid and pia mater)
In elderly patients what must be considered as a potential trigger for meningitis?
Varicella-zoster virus (shingles)
What is encephalitis?
Inflamation and infection of the brain parenchyma
What is encephalitis caused by?
- viral ( herpes/ virecella)
- bacterial
-fungal
Clinical features of encephalitis?
- behavioural changes and personality shifts
- neuro deficits
- seizures and altered mental status
