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Neuro AM > Degenerative diseases of the CNS > Flashcards

Degenerative diseases of the CNS Flashcards

1
Q

What are the common features of neurodegenerative disease?

A 
Aetiology largely unknown
Usually late onset
Gradual progression
Neuronal loss
Structural imaging often normal
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2
Q

What is dementia?

A

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

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3
Q

What are the causes of late onset dementia?

A

Alzeheimer’s
Vascular
Lewy body
Other

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4
Q

What are the causes of early onset dementia?

A

Alzeheimer’s
Vascular
Frontotemporal
Other

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5
Q

What is the most common cause of dementia?

A

Alzeheimer’s

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6
Q

What are the treatable causes of dementia?

A

B12 deficiency
Thyroid disease
Infective

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7
Q

What are the infective causes of dementia?

A

HIV

Syphilis

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8
Q

What mimics dementia?

A

Hydrocephalus
Tumour
Depression

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9
Q

How is dementia diagnosed?

A

History
Examination
Investigations

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10
Q

What history is taken to diagnose dementia?

A

Type of deficit
Progression
Risk factors
Family history

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11
Q

What examinations should be done to diagnose dementia?

A

Cognitive functions
Neurological
Vascular

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12
Q

What are the domains of cognitive function?

A 
Memory
Attention
Language
Visuospatial
Behavious
Emotion
Executive function
Apraxias
Agnosias
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13
Q

What are the screening tests for cognitive function?

A

Mini mental

Montreal

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14
Q

What investigations are done to diagnose dementia?

A 
Bloods
CT/MRI
CSF
EEG
Functional imaging
Genetics
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15
Q

What are the clues towards diagnosis of dementia?

A

Type of cognitive deficit
Abnormal movements
Parkinsonism
Myoclonus

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16
Q

What does a rapid progression of dementia point towards?

A

CJD

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17
Q

What does a stepwise progression of dementia point towards?

A

Vascular dementia

18
Q

What do abnormal movements point towards?

A

Huntington’s

19
Q

What does Parkinsonism point towards?

A

Lewy body

20
Q

What does myoclonus point towards?

A

CJD

21
Q

What is ALzeheimer’s caused by?

A

Tempero-parietal dementia

22
Q

What are the characteristic features of Alzheimer’s?

A

Early memory disturbance
Language and visuospatial problems
Personality preserved until later

23
Q

What are the characteristic features of frontotemporal dementia?

A

Early hang in personality/behaviour
Change in eating habits
Early dysphagia
Memory/visuospatial preserved until later

24
Q

What are the characteristic features of vascular dementia?

A

Mixed picture

Stepwise progression

25
Q

What is the non pharmacological symptomatic treatments of dementia?

A

Information and support
Occ health
Social work, social respite, placement

26
Q

What are the pharmacological symptomatic treatments of dementia?

A

Treat insomnia, behaviour, depression

27
Q

What are the specific treatments of Alzheimer’s?

A

Cholinesterase inhibitors

NMDA antagonist

28
Q

What are the effects of cholinesterase inhibitors in Alzheimer’s?

A

Small symptomatic improvement

No delay in institutionalisation

29
Q

What is Parkinsonism?

A 
Clinical syndrome with more than 2 of
Bradykinesia
Rigitity
Tremor
Postural instability
30
Q

What causes Parkinsonism?

A

Dopamine loss in basal ganglia

31
Q

What are the causes of Parkinsonism?

A

Idiopathic
Drug induced
Vascular
Parkinson’s plus syndromes

32
Q

What are the symptoms of Parkinson’s plus syndromes?

A

Multiple system atrophy
Progressive supra nuclear palsy
Corticobasal degeneration

33
Q

How is Parkinsonism diagnosed?

A

Clinically
Bradykinesia with >1 of tremor, rigidity and postural instability
Slow progressive
Asymmetric rest tremor
Good response to dopamine replacement therapy

34
Q

What signs make Parkinson’s less likely?

A 
Rapid progression
Symmetrical
Lack of rest tremor
Poor response to treatment
Early falls and dementia
Other abnormal neurological signs
35
Q

What are the drug induced complications of Parkinson’s?

A

Motor fluctuations
Dyskinesia
Hallucinations
Lack of impulse control

36
Q

What causes motor fluctuations in Parkinson’s?

A

Levodopa wearing off

37
Q

What causes dyskinesia in PArkinson’s?

A

Levodopa

38
Q

What are the non drug induced complications of Parkinson’s?

A 
Depression
Dementia
Autonomic- BP, bladder, bowel
Speech, swallow
Balance
39
Q

What is the treatment of Parkinson’s?

A

Levodopa- dopamine precursor

40
Q

What are the late drug treatments of Parkinson’s?

A

Prolong levodopa half life
Oral dopamine antagonist
Continuous infusion

41
Q

What is the late treatment of Parkinson’s?

A

Deep brain stimulation

42
Q

What drugs are used to prolong the levodopa half life?

A

MAO-B inhibitors
COMT inhibitors
Slow release levodopa

Neuro AM (38 decks)

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