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NEUROLOGY AND NEUROSCIENCE 2 > DEMENTIA > Flashcards

DEMENTIA Flashcards

1
Q

What is the commonest cause of dementia?

A

Alzheimer’s disease

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2
Q

What is dementia characterised by?

A

Progressive cognitive, social and functional impairment

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3
Q

What can be given to dementia patients early on to provide modest symptomatic benefit?

A

Acetylcholinesterase inhibitors

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4
Q

Name the common causes of dementia

A

Alzheimer’s disease
Vascular dementia
Frontotemporal dementia
Dementia with Lewy bodies

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5
Q

What are some potentially reversible causes of dementia?

A 
Depression
Alcohol related brain damage
Endocrine
B1/B1112/B6 deficiency
Benign tumours
Infections
Inflammatory
Limbic encephalitis
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6
Q

What is the pattern of cognitive function in dementia patients over the years?

A

Overall decrease but with many ups and downs which has many factors affecting

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7
Q

Why is it hard to accurately diagnose dementia in clinics?

A
  • Disease follows a heterogenous course
  • In old age the disease presentation if of multiple co-
    morbidities
  • Lots of mixed and uncertain pictures
  • Often has mixed pathologies
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8
Q

What can cause delusions/hallucinations in dementia patients?

A

Alcohol withdrawl/dependence

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9
Q

If there are subtle deteriorations in symptoms which subtype of dementia is that indicative of?

A

Alzheimer’s disease

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10
Q

If there are large deteriorations in symptoms which subtype of dementia is that indicative of?

A

Vascular dementia

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11
Q

What investigations can you undertake for dementia?

A

Neuropsychology (MMSE for cognitive function)
Bloods
MRI
PET

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12
Q

What 2 tests can be undertaken to evaluate a dementia patient’s cognitive function?

A 
Mini-mental state examination (MMSE)
ACE III (more memory focused)
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13
Q

What blood investigations can be undertaken in dementia patients?

A

Affecting cognition:

  • Full blood count
  • Inflammatory markers
  • Thyroid function
  • Biochemistry and renal function
  • Glucose
  • B12/folate
  • Clotting

Other causes of dementia:

  • Syphilis serology
  • HIV
  • Caeruloplasmin
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14
Q

As dementia progresses what can be seen on an MRI?

A

Narrow sulci/widened gyri

Dilated ventricles

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15
Q

What two proteins are characteristic of Alzheimer’s disease?

A

Amyloid and Tau

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16
Q

Describe the management of dementia

A 
Acetylcholinesterase inhibitora
Watch and wait
Treat behavioural/psychological symptoms
OT/social services
Specialist therapies
17
Q

How does Alzheimer’s usually present?

A

Subtle, insidious amnestic/non amnestic

Initial episodic memory deficits secondary to dysfunction of medial temporal lobe structures

18
Q

How does vascular dementia usually present?

A

Related to cerebrovascular diseases with classical step-wise deterioration +- multiple infarcts

19
Q

How does dementia with Lewy bodies present?

A

Cognitive impairment before/within 1 year of parkinsonian symptoms, visual hallucinations, fluctuating cognition and REM sleep disorder

20
Q

How does frontotemporal dementia present?

A

Behavioural variant FTD, semantic dementia, progressive non-fluent aphasia

21
Q

How can you analyse the levels of amyloid and tau in patients?

A

Antibody histochemistry
PET scan
Lumbar puncture to analyse CSF

22
Q

Which medial temporal lobe structures are affected in Alzheimer’s?

A

Entorhinal cortex

Hippocampus

23
Q

What is the difference between AD and DLB on MRI

A

Alzheimer’s: atrophied hippocampus

Lewy bodies: preserved hippocampus volume

24
Q

What would an MRI of a patient with frontotemporal dementia look like?

A

Lateral fissure volume loss
Temporal lobes volume loss
Frontal opercula volume loss

25
Q

What is the pathology behind Alzeihmer’s disease?

A

Amyloid precursor proteins cleaved to form extracellular amyloid beta plaques which interfere with neuronal communication. These plaques trigger the phosphorylation of tau. Tau hyperphosphorylation undergoes oligomerization and aggregates into intracellular neuro-fibrillary tangles (NFTs) that disrupt the microtubular system and result in hippocampal atrophy

26
Q

What protein deposition is concerned with Lewy-Body dementia?

A

Alpha-synuclein protein deposition

NEUROLOGY AND NEUROSCIENCE 2 (9 decks)

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