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brs2 > dementia > Flashcards

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
Q

why is diagnosis of alzheimers probable

A

diagnosis can only be made certain post mortem

26
Q

how can we trace amyloid plaques

A

use tracer called atf and use pet scan to trace plaques

can also look at csf via lumbar puncture

27
Q

what is alzheimers disease

A

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
Q

typical case of presentation of lewy body dementia

A

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
Q

what would you see in examination in someone with lewy body

A 
aware of recent news events
no evidence of altered behaviour
mmse 28/30, errors on attention
no evidence of parkinsonism
investigations arranged
30
Q

describe dementia with lewy bodies

A 
associated with fluctuating cognition
often visual hallucinations
rem sleep disorder
high risk of falls
development of symptoms associated with parkinsons disease
31
Q

what can be seen in investigations in ftd

A

blood tests

mri showed extensive volume loss in temporal lobes and frontal opercula

32
Q

expect to see in ftd

A

anger fusration
rude
lack of hygiene
frequent paraphrasic errors

brs2 (65 decks)

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