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Nervous System > Degenerative Diseases of CNS > Flashcards

Degenerative Diseases of CNS 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 interface in occupational and social role

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2
Q

what are the 3 most common causes of late onset dementia?

A

> alzheimers
vascular
lewy body

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3
Q

what are the 3 most common causes of dementia in young onset?

A

> alzheimers
vascular
fronototemporal

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4
Q

name a genetic cause of young onset dementia

A

huntingtons

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5
Q

what infections can cause dementia?

A

> HIV

> CJD

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6
Q

what inflammatory conditions cause dementia?

A

MS

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7
Q

what are some treatable conditions of dementia?

A

> B12 deficiency
thyroid disease
HIV
syphilis

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8
Q

what conditions can mimic dementia?

A

> hydrocephalus
tumour
depression

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9
Q

how is dementia diagnosed?

A

> history from independent witness
examination of cognitive function, neurological and vascular
blood, CT/MRI investigations

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10
Q

what investigations would you carry out for dementia?

A 
> bloods
> CT/MRI
(> CSF
>EEG
> functional
> genetics)
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11
Q

name 2 cognitive function screening tests

A

> mini-mental (MMSE)

> montreal (MOCA)

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12
Q

what clues are there to diagnoses of dementia?

A 
> type of cognitive deficit
> speed of progression
> abnormal movements (huntingtons)
> parkinsons (lewy body)
> myoclonus (CJD)
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13
Q

how does CJD dementia progress?

A

rapidly

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14
Q

how does vascular dementia progress?

A

stepwise

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15
Q

what is the commonest neurodegenerative condition?

A

alzheimer’s disease

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16
Q

describe the dementia in alzheimer’s

A

> temporo-parietal disturbance
early memory disturbance
language and visuospatial problems
personality preserved until later

17
Q

describe fronto-temporal dementia

A

> early change in personality
change in eating habits
early dysphasia
memory/visuospatial relatively preserved

18
Q

how does vascular dementia decline?

A

stepwise

19
Q

what non-pharmacological symptomatic treatment is there for dementia?

A

> information and support
OT
social support
voluntary organisations

20
Q

what symptoms can you treat pharmacologically for dementia?

A

> insomnia
behaviour
depression

21
Q

what specific treatment is there in alzheimers?

A

> cholinesterase inhibitors (donepezil)

> NMDA antagonist

22
Q

name some clinical signs that are present in parkinsonism

A

> bradykinesia (slowness of movement)
rigidity (stiffness)
tremor (shakiness)
postural instability (unsteadiness/falls)

23
Q

in parkinsonism what neurotransmitter is lost?

A

dopamine

24
Q

name some causes of parkinsonism

A 
> idiopathic dementia with lewy bodies
> drug induced
> vascular
> multiple system atrophy
> progressive supranuclear palsy
25
Q

describe the clinical diagnosis of parkinsonism

A

> bradykinesia with tremor, rigidity or postural instability
slow progression
supported by asymmetric rest tremor and good response to dopamine replacement treatment

26
Q

what imaging is used to view the basal ganglia in parkinsonism?

A

dopamine transporter SPECT

27
Q

name 4 early medication treatment in parkinsons

A

> levodopa
COMT inhibitor
MAO-B inhibitor
dopamine agonists

28
Q

what drug stops levodopa being converted to 3OMD?

A

COMT inhibitor

29
Q

what does levodopa become in the synaptic terminal?

A

L-DOPA

30
Q

what is the action of MAO-B inhibitor?

A

it converts dopamine to DOPAC

31
Q

what are some drug induced later complications of parkinsons?

A

> motor fluctuations as levodopa wears off
dyskinesias
psychiatric (hallucinations, impulse control)

32
Q

name some non-drug induced later complications of parkinsons

A 
> depression
> dementia
> autonomic
> speech
> balance
33
Q

what drugs prolong the levodopa half life?

A

> MAO-B inhibitors
COMT inhibitors
slow release levodopa

34
Q

what is the late treatment for parkinsons?

A

> drugs-oral dopamine agonist, continuous infusion
functional neurosurgery
allied health professionals

Nervous System (45 decks)

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