Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

C3 CLINICAL > Clinical presentations of Dementia > Flashcards

Clinical presentations of Dementia Flashcards

1
Q

Define Dementia

A

Dementia is a clinical syndrome of progressive cognitive decline with impaired social or occupational functioning

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

In people over the age of 80 how many people will have dementia?

A

1 in 5 people

Much less common in younger people

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the commonest in people over age of 65?

A

Alzheimer’s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Beyond Alzheimer;s what does the balance of disease change with?

A

Age of onset

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is extremely rare in younger people?

A

Lewy bodies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is very important clinically?

A

Frontal temporal dementia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What does Dementia refer to?

A

Particular pattern of changes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the common pattern of cognitive impairment for AD?

A
  1. Episodic (and topographical) memory initially
  2. Early parietal deficits visuo-perceptual, visuo-spatial, calculation,praxis
  3. Later global cognitive impairment
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the common pattern of cognitive impairment for DLB?

A
  1. Executive dysfunction
  2. Visual hallucinations
  3. Parietal lobe deficits/episodic memory
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the common pattern of cognitive impairment for FTLD?

A
  1. Behavioural/personality changes
  2. Executive dysfunction
  3. Language-specific subtypes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the common pattern of cognitive impairment for VaD?

A
  1. Cognitive slowing

2. Executive dysfunction + can affect other lobes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the profiles seen on the neuropsychological tests mapped onto?

A

Particular hallmarks of atrophy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What does Alzheimer’s produce problems within?

A

Selective early hippocampi

- The medial temporal lobe

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What do Semantic dementia produce problems within?

A

Understanding of speech

- The left temporal lobe

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What does Primary progressive aphasia (PPA) affect?

A

The frontal lobe of the brain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What do profile on the scans go with?

A

Profile we see neuropsychologically

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What does Neuroimaging contribute?

A
  1. Exclusion of surgically remediable lesion
  2. Diagnostic positive predictive value
  3. Detection and quantification of change
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is a framework for understanding (degenerative) dementias?

A
  1. Genetic/ other risk factors
  2. Abnormal protein deposited in the brain
  3. Loss of brain cells (brain atrophy)
  4. Altered neuro-transmitter function
  5. Symptoms and signs of the disease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is a risk factor for the acceleration of the early onset of Alzheimer’s?

A

APOE4

not used clinically but mentioned dermatologically

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is the genetics of Alzheimer’s disease?

A
  1. APP
  2. PS1
  3. PS2
  4. ApoE4
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is the abnormal protein deposited in the brain for Alzheimer’s disease?

A
  1. Amyloid

2. Tau

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is the brain atrophy for Alzheimer’s disease?

A

Hippocampal atrophy initially then whole brain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is the altered neuro-transmitter function of Alzheimer’s disease?

A

Cholinergic

24
Q

What are the symptoms and signs of Alzheimer’s disease?

A

Episodic memory problems

later global deficits

25
Q

What is serial scan used for?

A

Repeated Imaging

Look at brain shrinkage

26
Q

What is the process of a serial scan?

A

Register the scans onto a common space and measure whether there has been a change in brain volume

Quantify the change by putting a colour on it

27
Q

What is Alzheimer’s disease summary?

A
  • The most common disease-causing dementia and most closely associated in the public mind
  • Insidious onset, usually early memory impairment
  • Later global cognitive deficits
  • Neurological examination normal early in disease
  • Amyloid plaques & (tau-positive) neurofibrillary tangles
  • Deficiency of acetylcholine biochemically
  • Initially hippocampal atrophy, later global cerebral atrophy
28
Q

What does posterior cortical atrophy have (PCA)?

A
  1. Visual disorientation
  2. Led by visuospatial awareness
  3. Early prominent involvement of parietal cortex & occipital cortex
29
Q

What is the abnormal protein deposited in the brain for dementia with Lewy bodies?

A

Alpha-synuclein

30
Q

What is the brain atrophy for dementia with Lewy bodies?

A

Posterior or generalised

31
Q

What is the altered neuro-transmitter function?

A
  1. Dopaminergic

2. Cholinergic

32
Q

What are the symptoms and signs of Dementia with Lewy bodies?

A
  1. Visual hallucinations
  2. Cognitive decline
  3. Fluctuations
  4. Parkinsonism
33
Q

Dementia with Lewy Bodies summary

A

• Extensive overlap (? continuum) with Parkinson’s disease
• Cognitive decline often includes prominent attentional, executive as well as posterior cortical deficits, memory variable
• Other key features:
- Visual hallucinations
- Fluctuations in cognition
- REM sleep disorder
- Parkinsonism
• Relative ‘absence’ of disproportionate hippocampal atrophy on MRI

34
Q

What is the genetics for FTLD?

A
  1. MAPT
  2. Progranulin
  3. C9ORF72
  4. CHMP2B
  5. VCP
  6. TBK1
35
Q

What is the abnormal protein deposited in the brain for FTLD?

A
  1. Ubiquitin (TDP-43)

2. Tau

36
Q

What is brain atrophy for FTLD?

A

Fronto-temporal atrophy

37
Q

What is altered neuro-transmitter function of FTLD?

A
  1. Serotonergic

2. Dopaminergic

38
Q

What are the symptoms and signs of FTLD?

A

Behavioural or language deficits

39
Q

What is the macroscopic pathology of FTLD?

A
  • Classically ‘’knife-blade’’ frontotemporal atrophy but severity variable
  • Variable involvement of parietal lobes
  • Subcortical structures (amygdala, hippocampus, basal ganglia, thalamus) frequently involved
  • They have loss of insight
40
Q

What is progressive prosopagnosia?

A

a clinical syndrome characterized by a progressive and selective inability to recognize and identify faces of familiar people

41
Q

What is the clinical feature of progressive prosopagnosia?

A

R temporal love atrophy overlap extensively with ‘frontal’ dementia

42
Q

What is sementic dementia syndrome closely associated with?

A

Focal L temporal atrophy and this constellation predicts ubiquitin pathology

43
Q

What is FTLD summary?

A
  • Paradigmatic ‘focal’ dementias
  • Genetically mediated in a significant proportion and this is likely to continue to expand
  • Behavioural and/or language-based presentations
  • Variable prominence of other neurological features (esp. parkinsonism)
  • Asymmetric atrophy with antero-posterior gradient on MRI
  • Some evidence for molecular imaging signatures
44
Q

What is progressive supranuclear palsy (PSP) + corticobasal degeneration (CBD)?

A

Overlapping clinical syndrome with parkinsonism plus other neurological and cognitive features, and various histopathological substrates

45
Q

what are features of PSP?

A
  1. Prominent executive deficits
  2. Gaze palsy (supranuclear)
  3. Early falls and parkinsonism esp affecting axial muscles
  4. May have midbrain atrophy on MRI
46
Q

What are features of CBD?

A
  1. Prominent parietal deficits
  2. Asymmetric limb apraxia, ridgity +- ‘alien limb’
  3. May have asymmetric fronto-parietal atrophy on MRI
47
Q

What signs does PSP: midbrain atrophy have on structural MRI?

A
  1. Mickey Mouse sign

2. Hummingbird sign

48
Q

What are the causes of vascular dementia?

A
  1. Large artery disease (including inflammatory)
  2. Cardiac embolic events
  3. Small vessel disease
  4. Thrombophilias
  5. Haematologic factors
  6. Haemodynamic mechanims
  7. Specific arteriopathies
  8. Haemorrhages (primary and secondary)
  9. Hereditary e.g. CADASIL, cerebral amyloid angiopathies
49
Q

What are the lesion types for vascular dementia?

A
  1. Arterial territorial infarct
  2. Distal field/watershed infarct
  3. Lacunar infarct
  4. Ischaemic white matter change
  5. Incomplete ischaemic injury
50
Q

What is the summary of vascular dementia?

A
  1. A range of causes including both sporadic and genetic vasculopathies
  2. Atherosclerosis is the most common but vasculitis is esp important as treatable
  3. Many cases lack conventional risk factors or clinical history of stroke
  4. Several MRI patterns possible
  5. Vessel disease often coexist with primary degeneration
51
Q

What are examples of the classification of Limbic encephalitis?

A
  1. Autoimmune
  2. Paraneoplastic
  3. Infections
  4. Connective tissue diseases/ vasculitides
  5. Mimic syndromes
52
Q

What are examples of autoimmune limbic encephalitis?

A
  1. LGI1 most common
  2. GABABR,
  3. AMPAR
  4. CASPR2
    - steroid responsive encephalopathies
53
Q

What are examples of Paraneoplastic limbic encephalitis?

A
  1. Small cell lung
  2. Testis
  3. Lyphoma
  4. Ovary
  5. Breast
54
Q

What is an example of infections in Limbic encephalitis?

A
  1. Herpesviruses (esp HSV2, HHV6/7)
55
Q

What are examples of connective tissue diseases/vasculitides?

A
  1. Behcets
  2. Sjogren’s
  3. Sarcoid
  4. Relapsing polychondritis
56
Q

What is an example of mimic syndrome?

A

Temporal lobe tumour

57
Q

What are the Limbic encephalitis summary?

A
  1. Causes include paraneoplastic and inflammatory (autoimmune). Expanding range of associations
  2. Syndrome of subacute memory impairment with confusion, psychiatric features/ behavioural change (limbic dysfunction)
  3. Fluctuation with more protracted episodes of altered conscioussness, abnormal movements (e.g. LGI1)
  4. Seizures common
  5. Temporal lobe abnormalities on MRI
  6. May respond to immunosuppressive treatments

C3 CLINICAL (27 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions