dementia Flashcards

1
Q

epidemiology of dementia

A

46 mill ppl live with it worldwide

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2
Q

is there a cure demetia

A

no but can use acetyl cholinesterase inhibitors

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3
Q

what is the most common cause of dementia

A

alzheimers disease

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4
Q

what is a illness that can mimic dementia

A

depression
alcohol related brain damage
endocrine causes
b1,12 and 6 deficiency

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5
Q

what are some other factors that can affect cognition

A

infection
sleep
eating and drinking properly?

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6
Q

why is it hard to accurately diagnose dementia

A

follows heterogenous course
in old age there are multiple co morbidities
uncertain history

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7
Q

what causes alzheimers disease

A

build up of amyloid plaques

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8
Q

what is clinic process for dementia

A
referral
history
examination
investigations
diagnosis
Management
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9
Q

checklist to interview patients and collateral

A
memory 
language
numerical skills
executive skills
visuospatial skills
sexual behaviour
eating
mood
personality and social conduct
anxiety
activities of daily living
delusions/hallucinations
*and chronology of each
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10
Q

what is dementia

A

severe loss of memory and other cognitive abilities which leads to impaired daily function - regardless of underlying cause

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11
Q

what are some investigations that can be done to test for dementia

A

neuropsychology examination
mri
pet
bloods

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12
Q

what is mmse

A

test that you can do on test or ace 11 which is a more memory tested

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13
Q

what do we check bloods for

A
inflammatory markers
thyroid function
biochemistry and renal function
glucose
b12 and folate
clotting
hiv
caeruloplasmin
syphilis serology
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14
Q

what can we use amyloid pet scans for

A

check for alzheimers

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15
Q

what are the differential diagnosis for dementia symptoms

A
alzheimers
vascular
lewy body
ftd
depression
delirium
non
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16
Q

how to manage dementia

A

acetylcholinesterase inhibitors
watch and wait
treat behaviour e.g antipsychotics
specialist therapy

17
Q

what is vascular dementia related to and how does it present

A

cerebrovascular disease with classical step wise deterioration possible with multiple infarcts

18
Q

how does alzheimers present

A

subtle, insidious amnestic/non amnestic presentations

19
Q

how does demential with lewy bodies present

A

cognitive impairment before/within 1 year of parkinsonian symptoms, visual hallucinations and fluctuating cognition

20
Q

how does frontotemporal dementia present

A

behavior variant ftd, smenatic dementia

progressive non fluent aphasia

21
Q

what does a typical case of probable alzheimers look like

A
patient asks same questions everyday
makes mistakes incl taking meds
cant make their way to familiar places
watching tv programmes/film for second time
increasingly irritable
22
Q

how do you examine a patient

A
head- turning sign - when theyve been asked a question
vague about recent events/sports
not certain about route to hospital
mini mental state examination
adenbrookes cognitive assessment
23
Q

what is episodic memory

A

memory for particular episodes in life

dependent on medial temporal lobes incl hippocampus

24
Q

what might you see in an mri of someone with alzheimers

A

shrinkage of hippocampus space replaced by csf - atrophy
more prominent gyri
brain looks shrinked

25
why is diagnosis of alzheimers probable
diagnosis can only be made certain post mortem
26
how can we trace amyloid plaques
use tracer called atf and use pet scan to trace plaques | can also look at csf via lumbar puncture
27
what is alzheimers disease
most common cause of neurodegenerative dementia typically involves initial episodic memory deficits secondary to dysfunction of medial temporal lobe structures (entohinal cortex and hippocampus)
28
typical case of presentation of lewy body dementia
able to do less than previously seems disorientated on some days but fine on others memory not specifically an issue can have daily visual hallucinations follow up appointment - develop shuffling gait with reduced facial expressions hallucinations decreased with rivastigmine
29
what would you see in examination in someone with lewy body
``` aware of recent news events no evidence of altered behaviour mmse 28/30, errors on attention no evidence of parkinsonism investigations arranged ```
30
describe dementia with lewy bodies
``` associated with fluctuating cognition often visual hallucinations rem sleep disorder high risk of falls development of symptoms associated with parkinsons disease ```
31
what can be seen in investigations in ftd
blood tests | mri showed extensive volume loss in temporal lobes and frontal opercula
32
expect to see in ftd
anger fusration rude lack of hygiene frequent paraphrasic errors