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Psychiatry > Cognitive Decline > Flashcards

Cognitive Decline Flashcards

1
Q

Describe episodic memory

A

A category of long-term memory that involves the recollection of specific events, situations, and experiences.
Examples - memory of first day of school, first kiss

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2
Q

Describe semantic memory

A

Long term memory that is not drawn from personal experience - includes general knowledge and word meanings

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3
Q

Describe procedural memory

A

Long-term memory which is responsible for knowing how to do things e.g. how to walk, how to ride a bike

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4
Q

What is antegrade amnesia?

A

Difficulty in acquiring new material and remembering events since the onset of the illness or injury

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5
Q

What is retrograde amnesia?

A

Difficulty in remembering information prior to the onset of illness or injury

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6
Q

What are the macroscopic changes seen in AD?

A

Widespread cerebral atrophy, particularly in the cortex and hippocampus

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7
Q

What are the microscopic changes seen in AD?

A

Cortical plaques due to the deposition of Amyloid-Beta protein and intraneuronal neurofibrillary tangles caused by the abnormal aggregation of tau protein

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8
Q

Hyperphosphorylation of which protein is linked to AD?

A

Tau

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9
Q

What is the first line pharmacological treatment of AD?

A

Acetylcholinesterase Inhibitors
- Donepezil
- Galantamine
- Rivastigmine

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10
Q

What is the second line pharmacological treatment for AD?

A

Memantine

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11
Q

When is memantine prescribed in AD?

A
  • moderate AD where intolerant or have a contraindication to acetylcholinesterase inhibitors
  • as an add-on to acetylcholinesterase inhibitors in moderate to severe AD
  • as a monotherapy in severe AD
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12
Q

True or False?
Donepezil is contraindicated in Bradycardia

A

True

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13
Q

How does vascular dementia usually present?

A

A history of several months/years of sudden or stepwise deterioration of cognitive function

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14
Q

What are some signs and symptoms of vascular dementia?

A

Focal neurological abnormalities - visual disturbance, sensory or motor symptoms
Difficulty with attention and concentration
Seizures
Memory disturbance
Gait disturbance
Speech disturbance
Emotional disturbance

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15
Q

What might an MRI of someone with vascular dementia show?

A

Infarcts and extensive white matter changes

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16
Q

What is the characteristic pathological feature of Lewy-Body Dementia?

A

Lewy bodies (alpha-synuclein cytoplasmic inclusions) in the substantia nigra, paralimbic and neocortical areas

17
Q

What are the features of Lewy-Body Dementia?

A

Progressive cognitive impairment (can be fluctuating)
Parkinsonism
Visual hallucinations

18
Q

What imagining can be used to determine a diagnosis of Lewy-Body dementia?

A

SPECT scan

19
Q

What is the pharmacological management of lewy body dementia?

A

1st line = acetylcholinesterase inhibitors (e.g. Donepezil)
2nd line = memantine

20
Q

What are the 3 recognised types of frontotemporal lobar degeneration?

A

Frontotemporal dementia (Pick’s Disease)
Progressive non-fluent aphasia (chronic progressive aphasia CPA)
Semantic dementia

21
Q

What is characteristic of Pick’s Disease?

A

Personality change and impaired social conduct
Other features - hyperorality, disinhibition, increased appetite

22
Q

What is the characteristic macroscopic appearance of a brain with Pick’s disease?

A

Frontal gyral atrophy with a knife blade appearance

23
Q

What are the microscopic changes associated with Pick’s Disease?

A

Pick bodies - spherical aggregations of tau proteins
Gliosis
Neurofibrillary tangles
Senile plaques

24
Q

What are the features of CJD?

A

Dementia (rapid onset)
Myoclonus

25
Q

What causes Wernicke’s encephalopathy?

A

Thiamine deficiency, most often seen in alcoholics

26
Q

What is the classic triad of symptoms seen in Wernicke’s encephalopathy?

A

Ophthalmoplegia/ nystagmus
Ataxia
Encephalopathy

27
Q

What is the treatment of Wernicke’s encephalopathy?

A

Urgent thiamine replacement

28
Q

What condition can result from untreated Wernicke’s?

A

Korsakoffs Syndrome

29
Q

What are the features of Korsakoff’s syndrome?

A

Antegrade amnesia - inability to acquire new memories
Retrograde amnesia
Confabulation

Psychiatry (4 decks)

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