Degenerative Disease Flashcards
What are common features of Neurodegenerative diseases?
Aetiology unknown
Gradual onset
Loss of neurons
Late onset
What is the definition of dementia?
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
What are the main risk factors for dementia?
Age
Alcohol
Genetic?
What are some of the causes of late onset dementia?
Alzheimers
Lewy Body
Vascular
What are some of the causes of ealry onset dementia?
Alzheimers
Vascular
Frontotemporal
Other
What are some of the OTHER causes of early onset dementia?
Alcohol
Genetic (Huntingtons)
Infection (HIV, CJD)
Inflammatory (MS)
What are some of the treatable causes of dementia?
Vit B12 deficiency
Endocrine - thyroid disease
Infective - HIV
What are some differentials associated with dementia?
Hydrocephalus (NP)
Depression
Tumour
What investigations may be done in dementia?
Bloods
CT/MRI
LP - CSF for inflammatory markers
EEG
What tests may you carry out on examination?
MMSE
MOCA
Neuropsychological test
What domains of cognitive function does the MOCA test?
Memory Attention Laguage Visuospatial Behaviour Emotion Executive function Apraxias Agnosias
What are some clues to diagnosing dementia?
Cognitive decline
Slow progression
In which type of dementia would a stepwise progression be observed?
Vascular
Which type of dementia is associated with Parkinsons?
Lewy Body
What is the commonest neurodegenerative condition?
Alzheimers
What symptoms will temporo-parietal dementia present with?
Early memory disturbance
Language & visuospatial problems
Personality preserved
What symptoms will be observed in fronts-temporal dementia?
Early change in personality & behaviour
Early dysphagia
Memory relatively preserved
What non-pharmacological treatments can be supplied for dementia patient?
Information & support
Social work
Occupational therapist
What specific pharmacological treatments can be given for Alzheimers disease?
Anticholinsterases (Donepezil, rivastigmine)
NMDA antagonist (mematine)
What treatment can be given in FT dementia?
None
What is Parkinsons disease?
A clinical syndrome with >2 of: Bradykinesia Tremor Ridigity Postrural Instability
Where is pathology observed in the brain of Parksinsons?
Loss of dominergic neurons in Basal ganglia
What are some of the causes of Parkinsons?
Idiopathic Parkinsons disease
Drug induced
Vascular parkinsons
What age does Parkinsons usually present?
70/80s
What helps to confirm diagnosis of parkinson’s?
Symptoms (bradykinesia & other symptom)
Response to dopamine replacement therapy
What type of medication can be given to parkinson’s patient?
Levadopa
COMT inhibitor
MOAB inhibitor
Dopamine agonist
When can motor fluctuations be observed in parkinson’s patient?
When Levodopa wears off
What parkinson’s drugs can be administered in continuous infusion?
Duodopa
Apomorphine
