Dementia

Question 1

Common features of frontotemporal lobar dementias

Answer 1

Onset before 65
Insidious onset
Relatively preserved memory and visuospatial skills
Personality change and social conduct problems

Question 2

mx of frontotemporal dementia

Answer 2

NICE do not recommend that AChE inhibitors or memantine are used in people with frontotemporal dementia

Question 3

DDX - dementia besides obvious ones

Answer 3

hypothyroidism, Addison's
B12/folate/thiamine deficiency
syphilis
brain tumour
normal pressure hydrocephalus
subdural haematoma
depression
chronic drug use e.g. Alcohol, barbiturates

Question 4

Risk factors for Alzheimer’s disease

Answer 4

Age
Family history
Down’s syndrome
Caucasian

Question 5

Pathological changes in Alzheimer’s

Answer 5

Widespread cerebral atrophy
Cortical plaques due to beta-amyloid proteins
Neurfibrillary tangles

Question 6

Non-pharm mx of Alzheimer’s

Answer 6

offering ‘a range of activities to promote wellbeing that are tailored to the person’s preference’

offering group cognitive stimulation therapy

group reminiscence therapy and cognitive rehabilitation

Question 7

Pharm mx of Alzheimer’s

Answer 7

Acetylcholinesteras inhibitors(donepezil)

Memantine

Question 8

when is donepezil contraindicated

Answer 8

Bradycardia

Question 9

Features of lewy body dementia

Answer 9

Progressive cognitive impairment
Early impairments in attention and executive function in comparison to Alzheimer’s
Parkinsonism
visual hallucinations

Question 10

Diagnosis of Lewy body dementia

Answer 10

Clinical

SPECT

Question 11

Recommended cognition assessment tool in gp

Answer 11

10-CS
6-CIT
GPCOG

Question 12

Why is neuroimaging performed in someone with dementia

Answer 12

in secondary care, neuroimaging is performed* to exclude other reversible conditions (e.g. Subdural haematoma, normal pressure hydrocephalus)

Question 13

Risk factors for vascular dementia

Answer 13

history of stroke/tia 
AF
HTN
DM
Hyperlipidaemia 
smoking

Question 14

Presentation of VD

Answer 14

Several months or several years of a history of a sudden or stepwise deterioration of cognitive function.

Question 15

NICE recommendation for diagnosis of vascular dementia

Answer 15

NINDS-AIREN criteria for probable vascular dementia

Question 16

Pharm mx of vascular dementia

Answer 16

There is no specific pharmacological treatment approved for cognitive symptoms
Only consider AChE inhibitors or memantine for people with vascular dementia if they have suspected comorbid Alzheimer’s disease, Parkinson’s disease dementia or dementia with Lewy bodies.