Degenerative Disease

Question 1

What are common features of Neurodegenerative diseases?

Answer 1

Aetiology unknown
Gradual onset
Loss of neurons
Late onset

Question 2

What is the definition of dementia?

Answer 2

A syndrome consisting of progressive impairment of multiple domains of cognitive function in alert patients leading to loss of acquired skills & interference in social & occupational role

Question 3

What are the main risk factors for dementia?

Answer 3

Age
Alcohol
Genetic?

Question 4

What are some of the causes of late onset dementia?

Answer 4

Alzheimers
Lewy Body
Vascular

Question 5

What are some of the causes of ealry onset dementia?

Answer 5

Alzheimers
Vascular
Frontotemporal
Other

Question 6

What are some of the OTHER causes of early onset dementia?

Answer 6

Alcohol
Genetic (Huntingtons)
Infection (HIV, CJD)
Inflammatory (MS)

Question 7

What are some of the treatable causes of dementia?

Answer 7

Vit B12 deficiency
Endocrine - thyroid disease
Infective - HIV

Question 8

What are some differentials associated with dementia?

Answer 8

Hydrocephalus (NP)
Depression
Tumour

Question 9

What investigations may be done in dementia?

Answer 9

Bloods
CT/MRI
LP - CSF for inflammatory markers
EEG

Question 10

What tests may you carry out on examination?

Answer 10

MMSE
MOCA
Neuropsychological test

Question 11

What domains of cognitive function does the MOCA test?

Answer 11

Memory 
Attention 
Laguage
Visuospatial
Behaviour 
Emotion 
Executive function 
Apraxias
Agnosias

Question 12

What are some clues to diagnosing dementia?

Answer 12

Cognitive decline

Slow progression

Question 13

In which type of dementia would a stepwise progression be observed?

Answer 13

Vascular

Question 14

Which type of dementia is associated with Parkinsons?

Answer 14

Lewy Body

Question 15

What is the commonest neurodegenerative condition?

Answer 15

Alzheimers

Question 16

What symptoms will temporo-parietal dementia present with?

Answer 16

Early memory disturbance
Language & visuospatial problems
Personality preserved

Question 17

What symptoms will be observed in fronts-temporal dementia?

Answer 17

Early change in personality & behaviour
Early dysphagia
Memory relatively preserved

Question 18

What non-pharmacological treatments can be supplied for dementia patient?

Answer 18

Information & support
Social work
Occupational therapist

Question 19

What specific pharmacological treatments can be given for Alzheimers disease?

Answer 19

Anticholinsterases (Donepezil, rivastigmine)

NMDA antagonist (mematine)

Question 20

What treatment can be given in FT dementia?

Answer 20

None

Question 21

What is Parkinsons disease?

Answer 21

A clinical syndrome with >2 of:
Bradykinesia
Tremor
Ridigity 
Postrural Instability

Question 22

Where is pathology observed in the brain of Parksinsons?

Answer 22

Loss of dominergic neurons in Basal ganglia

Question 23

What are some of the causes of Parkinsons?

Answer 23

Idiopathic Parkinsons disease
Drug induced
Vascular parkinsons

Question 24

What age does Parkinsons usually present?

Answer 24

70/80s

Question 25

What helps to confirm diagnosis of parkinson’s?

Answer 25

Symptoms (bradykinesia & other symptom)

Response to dopamine replacement therapy

Question 26

What type of medication can be given to parkinson’s patient?

Answer 26

Levadopa
COMT inhibitor
MOAB inhibitor
Dopamine agonist

Question 27

When can motor fluctuations be observed in parkinson’s patient?

Answer 27

When Levodopa wears off

Question 28

What parkinson’s drugs can be administered in continuous infusion?

Answer 28

Duodopa

Apomorphine