Chronic Conditions 1.3 - Dementia

Question 1

What is the definition of dementia?

Answer 1

A cluster of symptoms caused. By loss of brain function

Question 2

How is the diagnosis of dementia conducted?

Answer 2

Through the ruling out of reversible causes

Question 3

Alzheimer’s disease

Answer 3

A progressive loss of cognitive function due to amyloid plaques and tau tangles

Question 4

What causes vascular dementia

Answer 4

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

Question 5

Risk factors for developing dementia?

Answer 5

• genetics (family history)
• head injuries
• lack of education or cognitive stimulation
• trisomy 21
• cholesterol levels
• diabetes

Question 6

What are amyloids?

Answer 6

Misfolded proteins that accumulate in the extracellular space

Question 7

What are common deposition sites for amyloids?

Answer 7

• kidneys (nephrotic syndrome)
• heart (cardiomyopathies)
• bowel (chron’s)

Question 8

How does amyloidosis have a specific association with Type 2 diabetes?

Answer 8

Amyloids are co-secreted w/ insulin and deposits in the islet of langerhans of the pancreas

Question 9

What is the clinical implication of amyloidosis?

Answer 9

Amyloid cannot be removed once deposited in the Extracellular space

Question 10

What chromosome does Alzheimer’s have a strong genetic link to

Answer 10

21

Question 11

Why do most individuals with Down syndrome develop Alzheimer’s by the age of 40?

Answer 11

This is because they have trisomy 21 which as we know amyloid deposition have a propensity towards the receptors in chromosome 21

Question 12

What are mimics of dementia?

Answer 12

• infectious
• nutritional deficiencies
• head trauma
• medication side effects

Question 13

What are the complications of brain atrophy in dementia?

Answer 13

There is a increased risk of bridging vein rupture or subarachnoid hemorrhage from trauma

Question 14

What medication can be used to treat dementia?

Answer 14

Cholinesterase inhibitors

Question 15

What is the definition of Parkinson’s?

Answer 15

A progressive neurodegenerative movement disorder

Question 16

What is the cause of Parkinson’s

Answer 16

Caused by a degeneration of dopaminergic neurons in the basal ganglia due to the disruption of the basal ganglia cortex feedback loop

Question 17

Why do the symptoms of Parkinson’s arise?

Answer 17

Because of the decrease cortical stimulation and motor signal coordination

Question 18

What is the definition of Huntington’s disease

Answer 18

A degenerative disease of the basal ganglia that affects the GABAergic neurons

Question 19

What causes huntingtons?

Answer 19

Caused by a degeneration of GABAergic inhibitory neurons which leads to random muscle movements (chorea)

Question 20

What symptoms in huntingtons occur in lates stages?

Answer 20

• gait instability or urinary incontinence

Question 21

Which chromosome mutation can cause huntingtons?

Answer 21

Chromosome 4

Question 22

What is the definition of systemic lupus erythematosus

Answer 22

A chronic systemic autoimmune disorder with relapsing and remitting flares

Question 23

What is antigen-antibody complex formation with regard to SLE

Answer 23

Complexes that form when antibodies bind to antigens which are then deposited into tissues triggering inflammatory damage and complement activation

Question 24

What is complement activation?

Answer 24

When complement proteins form a membrane attack complex to destroy perceived threats

Question 25

What can trigger SLE?

Answer 25

• UV light exposure
• Stress
• Infection

Question 26

What are the manifestations of SLE

Answer 26

-fatigue, fever and malaise
- malar rays across the nose and cheek
- raynauds
- MSK symptoms
- organ inflammation (Kidneys, Heart, Lungs)

Question 27

What is the definition of Cellulitis?

Answer 27

Bacterial infection of skin and subcue tissue

Question 28

Cellulitis is commonly cause by…

Answer 28

Staphylococcus aureus or group A strep

Question 29

What are risk factors for Cellulitis?

Answer 29

• trauma
• surgical wounds
• neuropathy

Question 30

How are neonates at risk for meningitis?

Answer 30

• group b strep or E. coli contamination

Question 31

What is the definition of meningitis?

Answer 31

Inflammation of the leptomininges (arachnoid and pia mater)

Question 32

In elderly patients what must be considered as a potential trigger for meningitis?

Answer 32

Varicella-zoster virus (shingles)

Question 33

What is encephalitis?

Answer 33

Inflamation and infection of the brain parenchyma

Question 34

What is encephalitis caused by?

Answer 34

• viral ( herpes/ virecella)
• bacterial
  -fungal

Question 35

Clinical features of encephalitis?

Answer 35

• behavioural changes and personality shifts
• neuro deficits
• seizures and altered mental status