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Neurology System > Degenerative Diseases > Flashcards

Degenerative Diseases Flashcards

1
Q

What is dementia?

A

Progressive impairment of multiple domains of cognitive function in alert patient leading to loss of acquired skills and interference in occupational and social role

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2
Q

What type of diagnosis is dementia?

A

Clinical diagnosis

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3
Q

What does the diagnosis for dementia consist of?

A

History and examination

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4
Q

How is dementia commonly seen in older people?

A

Memory generally worsens

Becoming more forgetful and start doing odd things

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5
Q

Who does dementia commonly affect?

A

Disease of the elderly

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6
Q

As age increases how does dementia risk change?

A

Dementia risk increases

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7
Q

What are the causes of late onset dementia?

A

Alzheimer’s
Vascular dementia
Lewy body

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8
Q

What are the causes young onset dementia?

A

Alzheimer’s
Vascular
Frontotemporal
Other - alcohol, genetics (huntington’s), infection (HIV), inflammatory (MS)

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9
Q

How is dementia diagnosed?

A

History
Examination
Investigations

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10
Q

What investigations should be done for dementia?

A 
Routine bloods 
CT/MRI 
CSF 
EEG
Genetics
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11
Q

Can just a patient history give you a diagnosis for dementia?

A

No

You need an independent witness history

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12
Q

What should be examined for suspected dementia?

A 
Memory attention span 
Language 
Behavioural 
Emotion 
Executive function 
Apraxias 
Agnosias
Neuropsychological assessment
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13
Q

What is the speed of progression in CJD?

A

Rapid

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14
Q

What is the speed of progression in vascular dementia?

A

Stepwise progression

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15
Q

What can added sign of abnormal movements suggest?

A

Huntington’s

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16
Q

Which type of dementia is suggested with Parkinsonism?

A

Lewy body

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17
Q

What is the commonest neurodegenerative condition?

A

Alzheimer’s disease

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18
Q

What are the signs of temporo-parietal dementia?

A

Early memory disturbance
Language and visuospatial problems
Personality preserves until later

19
Q

What are the signs of frontotemporal dementia?

A

Early change in personality and behaviour
Often change in eating habits
Early dysphagia
Memory/visuospatial relatively reserved

20
Q

What is the non-pharmalogical Rx for dementia?

A 
Information and support 
Dementia services
OT 
Social work 
Respite 
Voluntary organisations
21
Q

What is the specific treatment for frontotemporal dementia?

A

None available

22
Q

What is the specific Rx for alzheimers +/- lewy body dementia?

A 
Cholinisterase inhibitors  
Donepezil
Rivastigmine 
Galantamine 
NMDA antagonist
23
Q

What is parkinsonism?

A 
A clinical syndrome with  2 of:
Ð	Bradykinesia (slowness of movement)
Ð	Rigidity (stiffness)
Ð	Tremor (shakiness)
Ð	Postural instability (unsteadiness / falls)
24
Q

Where is the pathology in parkinsonism?

A

Basal ganglia

25
Q

What is lost in the pathology of parkinsons disease?

A

Dopanergic neurons

26
Q

What can cause parkinsonism?

A

Idiopathic
Drug induced (dopamine antagnosits)
Lewy body dementia

27
Q

Is parkinson’s more common in M or F?

A

M

28
Q

What is the clinical diagnosis for parkinson’s?

A

2 of 3
Bradykinesia
Tremor
Rigidity

29
Q

What type of tremor does parkinson’s have?

A

Resting

Pill rolling

30
Q

What is the response of parkinson’s to dopamine replacement therapy?

A

Good response

31
Q

What is the diagnosis for parkinson’s supported by?

A

Supported by asymmetric rest tremor, good response to dopamine replacement treatment

32
Q

Does parkinson’s have a fast progression?

A

No it is slowly progressive (5-10 yrs)

33
Q

What are later drug induced complications of parkinson’s?

A

Motor fluctuations - levodopa wears off
Dyskinesias - involuntary movements (levodopa)
Psychiatric - hallucinations, impulse control

34
Q

Treatment for Parkinsons?

A

Levodopa
Dopamine agonist
COMT inhibitors
MAO-B inhibitors

35
Q

How do MAO-B inhibitors work?

A

Prevent the breakdown of dopamine to the brain

36
Q

How do COMT inhibitors work?

A

Block an enzyme that breaks down levodopa

37
Q

What is bradykinesia?

A

Slow motor movement

38
Q

What is the effect of alcohol on parkinson’s tremor?

A

No effect

39
Q

What are bradykinesia signs of parkinson’s?

A

Shuffling gait
Slow to initiate movements
Lack of arm swing
Unable to turn around quickly

40
Q

What are hypertonia signs of parkinsons?

A

Rigidity

Cogwheel

41
Q

What are extra signs in parkinson’s?

A

Constipation
Postural instability
Soft voice
Low mood

42
Q

Where is the pathology in Parkinson’s?

A

Substantia nigra

Basal ganglia

43
Q

What investigations are done for parkinson’s?

A

None

It is a clinical diagnosis

Neurology System (35 decks)

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