Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

MB3 Psychiatry > Dementia > Flashcards

Dementia Flashcards

1
Q

what is the yerkes-dodson curve

A

low anxiety have poor arousal/performance
moderate stress and anxiety have correlation to good arousal and persormance
high levels of anxiety impair performance significantly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

how long does the short term memory last

A

<1min

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what is the implicit long term memory

A

unconscious memory leading to procedural memory

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what is the explicit long term memory

A

conscious memory split into semantic and episodic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

4 stages of memory processign

A

attention
encoding
storage
retrieval

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what is anterograde memory loss

A

difficulty acquiring new material and remembering since injury/disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what is retrograde memory loss

A

difficulty remembering info prior to onset of illness/injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

true/false - dementia leads to clouding of consciousness

A

FALSE!!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

questions to ask patients with memory loss

A 
does this affect day to day functioning?
any kitchen issues?
follow the news?
use appliances?
recent accidents?
enjoy hobbies?
lost or disorientated?
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

assessment of orientation of patient?

A

name
address
where are we
day, date, month, year, time

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

assessment of attention of patient?

A

can you read or watch tv

assess attention formally

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

assessment of memory of patient?

A 
why are you here?
how long have you been here?
do you forget conversations?
do you forget names?
do you repeat yourself?
name of doctor?
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

assessment of mood of patient?

A

do you feel anxious or worried

how has your mood been

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what is the 4AT test

A

assessment for delirium

moderate to severe cognitive impairment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

components of the 4AT

A

alertless - normal, sleepy, abnormal
AMT-4 - age, DOB, place, year
attention by months backwards
acute/fluctuating

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

bedside cognitive tests?

A

GPCOG
6CIT
clock drawing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

MMSE scoring and advantages

A

at least 24/30
quick
blank pen and paper
memorised by clinician

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

MMSE disadvantages

A

not age adjusted
poor for exec function
poor in severe impairment
may not address early issues

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

ACE-III scoring?

A

100 with 5 domains

cut off 88/82

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

uses for neuropsychological assessment

A

areas of deficit and preserved functioning in cog profile
info regarding prognosis
baseline functioning assessment
inform and facilitate intervention and strategies
monitor cognitive function
indicator of recovery
effectiveness of intervention

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what is dementia

A

progressive and irreversible global cognitive decline with associated loss of functioning

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

diagnostic testing for dementia?

A 
hx of global decline of months to years 
cognitive test corroborating hx 
no reversible cause 
collateral hx 
OT assessment
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what test is the standard cognitive test in diagnosis of dementia

A

ACE-III

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

what test can be used in patients unable to do the addenbrookes

A

MoCA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

when would detailed neuropsychological testing be indicated in a patient

A

those expected to do well in addenbrookes or younger patients with no radiological features on CT/MRI/SPECT

26
Q

what is often assessed at OT assesment of dementia

A 
activities 
washing 
dressing 
using phone 
shopping 
basic cooking
27
Q

possible reversible causes of cognitive impairment?

A 
delirium
alcohol
substance misuse 
neurological infection or inflammation 
brain lesions and SOLs 
depression 
medications 
thyroid or other metabolic/endocrine
28
Q

what is mild cognitive impairment

A

cognitive impairment with little deteriration of function
MoCA 24-26 and ACE-III 75-90
repeat annually

29
Q

what is subjective cognitive impairment

A

patients feels they have an impairment but testing and day to day function and normal
association to anxiety/depression or friend/relative with dementia
increased anxiety about memory causes more lapses

30
Q

what is the general outpatient pathway for someone with dementia

A

referral to any >55 with suspected dementia
nurse led memory clinic for MSE and cognitive tesing
consultant review and imaging
follow up
diagnosis
CMHT and post diagnostic support

31
Q

clinical features of AD?

A

memory loss - short term
dysphasia
dyspraxia
agnosia

32
Q

CT/MRI features of AD

A

normal
medial temporal atrophy
temporoparietal atrophy

33
Q

variants of AD

A

frontal

posterior cortical atrophy

34
Q

clinical features of vasc dementia ?

A 
dysphasia 
dyscalculia 
frontal lobe and affective symptoms 
focal neuro signs 
vascular risk factors 
stepwise decline
35
Q

CT/MRI and SPECT features of vascular dementia

A

CT/MRI - medium to severe vascular disease or multiple lacunar infarcts
SPECT - patchy reduction in tracer uptake through brain

36
Q

clinical features of behavioural FTD?

A 
behavioural change 
executive dysfunction 
impulsive 
lost social skills 
apathy 
diet change 
obsessive
37
Q

clinical features of primary progressive aphasia FTD?

A

effortful non fluent speech
lack of grammar
lack of words
articulatory error

38
Q

clinical features of semantic FTD?

A

impaired understanding of word meaning, fluent but empty speech, difficulty with names

39
Q

CT/MRI and SPEDCT features of FTD

A

CT/MRI have frontotemporal atrophy

reduced frontotemporal tracer uptake

40
Q

clinical features of DLB?

A 
two of the following 
visual hallucination 
flux in cognition 
REM sleep disorder 
parkinsonism but not >1y to dementia onset 
\+ve dat scan
41
Q

features of dementia with parkinsons disease

A

parkinsonism >1yrs to dementia onset
similar to lewy body but different pathology
+ve DAT scan

42
Q

when to suspect a less common cause dementia

A 
fast progression 
younger patient
neurological signs 
FHx of a rare cause 
clues in med Hx - HIV
something just isnt fitting right
43
Q

who to scan and with what with dementia

A

CT standard but not really advised if >80 and typical hx AD
MRI if young, fast progressing or atypical
SPECT for FTD or certain types AD
DAT scan for DPD/DLB when there arent enough supporting features

44
Q

cholinesterase inhibitors used in AD

A

donezepil
rivastigmine
galanramine

45
Q

cholinesterase inhibitors used in DLB and DPD

A

rivastigmine

donezepil

46
Q

how do cholinesterase inhibitors act to treat dementia and what types are they more effective in

A

slow cognitive decline

DLB/DPD over AD

47
Q

side effects of anticholinesterase inhibitors

A 
nausea 
diarrhoea 
muscle cramp
bradycardia 
worsening COPD/asthma
48
Q

what should you check before prescribing cholinesterase inhibitors and what is a contraindication

A

check pulse before prescription and dose increases

not for active PUD or severe asthma/COPD

49
Q

what is memantine, what dementia is it used for and what does it do

A

AD

slow cognitive declin and prevent BPSD

50
Q

what can memantine cause and what are possible side effects

A

HTN

sedation, dizziness, headache, constipation

51
Q

describe conditions surrounding dementia and driving

A

discuss at diagnosis
report to DVLA and allow pt to fill out form
doctor decides if pt can drive whilst DVLA investigates

52
Q

in middle and later stage dementia what aspects become more prevalent

A

behavioural and psychiatric

greater need for support and possible institutionalised care

53
Q

behavioural/psychological symptoms associated with dementia

A 
hallucination 
delusion 
insomnia 
anxiety
disinhibition 
agitation 
agression 
depression
54
Q

initial management of dementia within paitnets

A 
chart behaviours 
review physical symptoms, examine, investigate 
side effects of drugs?
comfort patient 
environment 
activity and exercise 
sleep hygiene 
carer education
55
Q

pharmacological management of FTD for agitation

A

trazodone

56
Q

pharmacological mx of agitation for AD

A

antipsychotics

citalopram, memantine, analgesia, dextromorphan

57
Q

drugs for depression in dementia

A

antidepressant and adjunct

58
Q

drugs for anxiety in dementia

A

antidepressant, BZD, pregabalin

59
Q

drugs for visual hallucination in dementia

A

cholinesterase inhibitors/antipsychotics

60
Q

drugs for insomnia in dementia

A

melatonin
z drugs
BZD
sedating antidepressants

61
Q

drugs for agitation/aggression in dementia

A 
BZD
antipsychotic 
sedating antidepressants 
cholinesterase inhibitors 
memantine 
pregabalin

MB3 Psychiatry (16 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions