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Year 3 Neuro > Dementia > Flashcards

Dementia Flashcards

1
Q

What is dementia

A

Progressive and chronic detiroration
Decline across mutiple cognitive domains
Memory most commonly affected

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2
Q

What the functional impairments of dementia

A

Agnosia
Anosognosia
Apraxia
Apathy

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3
Q

What are some RFs of Dementia?

A 
Age 
Genetics
Cog reserve
Cardiovascular RFs
Hearing loss 
Depression
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4
Q

What leads to a lesser cognitive reserve?

A

Leaving education early
Less job complexity
Social isolation

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5
Q

What are the stage of dementia?

A

Early
Middle
Late

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6
Q

What are the feature of early stage dementia?

A

Gradual onset

Forgetfulness
Losing track of time
Becoming lost in familiar places

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7
Q

What are the main features of vascular

A

Presumed vascular cause:
Atherosclerosis
Small vessel disease
Ischamia

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8
Q

What causes Alzheimers?

A

Most common form

Extracellular accumulation of amyloid plaques

Intracellular accumulation of neurofibrillary tangles

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9
Q

What is the difference between normal brain and a brain in someone with dementia?

A

Atrophy

Temporal lobes and hippocampus particualry affected
Can be seen on MRI

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10
Q

What are the main features of vascular dementia?

A

Presumed vascular cause:
Atherosclerosis
Small vessel disease
Ischeamia

Stepwise decline ‘plataeus’ then next insult causes decline again

Stroke is a major RF

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11
Q

What is the difference between normal brain and Alzheimers?

A

Atrophy

Temporal lobes and hippocampus particualry affected
Can be seen on MRI

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12
Q

What does Vascular dementia look like on a MRI?

A

White dots - areas of small vessel disease

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13
Q

What are the main features of LB dementia?

A

Deposition of alpha-synuclein

Age is biggest RF

Cog. signs:
Visual hallucination
Changes in alertness, concentration

Parkinsonian symptoms:
Movement disorders

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14
Q

What are the main features of Frontotemporal dementia?

A

Group of disorders when nerves are lost in frontal and temporal lobes causing them to shrink

Can affect behaviour, personality, language and movement

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15
Q

What is the treatment for dementia?

A

Medication
Mind-stimulating activities
Therapy
Lifestyle changes

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16
Q

What are some medications used in the treatment of Dementia?

A

Acetylcholinesterase inhibitors

e.g. donepezil, rivastigmine

17
Q

What are some medications used in the treatment of Dementia?

A

Acetylcholinesterase inhibitors
e.g. donepezil, rivastigmine

Meds to treat vascular RFs e.g. statins

Anti-psychotics e.g. haloperiodol and risperidone

Anti-depressants

18
Q

What are some non-pharmacolgical treatments for dementia?

A

Cognitive stimulation therapy

Cognitive rehabilitation

Remince on life

19
Q

What is delirium?

A

Common clinical syndrome that involves disturbed consciousness, cognitive function or perception which has an acute onset and fluctutating course

20
Q

What are the consequences of delirium?

A 
Longer hospital stay
Increased incidence of dementia
More HAIs
Increased chance of long term care e.g. nursing homes
More likely to die
21
Q

What are some RFs for Delirium?

A 
Age
Dementia 
Low eduational level 
Frailty
Depression
Poor nutrition
Surgery
22
Q

What are some signs of delirium?

A 
Distractible 
Inattentive
Drowsy/Hyperalert
Picking at clothes/sheets
Not getting out of bed
Generally unwell
23
Q

How do you diagnose delirium?

A

2 screening tools

4AT

CAM

24
Q

What is involved in the management in delirium

A

Treat underlying cause
Supportive care
Orientation (told the time, where they are, familiar items etc.)
Appropriate environment
Stop medicines that make it worse e.g. Anticholinergics like warfarin and furoesmide

25
Q

What medications are used in the treatment of delirium?

A

Not routinely used

Used to manage symptoms short-term

e.g. Anti-psychotics
Benzodiazepines (Lorazepam)

26
Q

What is the leading cause of disability worldwide?

A

Depression

27
Q

What is the core symptom of depression?

A

Feeling down/depressed/hopeless

28
Q

What is pseudo-dementia?

A

Depression related cognitive dysfunction

29
Q

What are the symptoms of pseudo-dementia?

A

Memory issues
Deficits in executive functions
Deficits in speech and language

30
Q

How do you recognise depression in the elderly?

A

Geriatric depression scale
15 point questionnaire

CORNELL Score if they cannot answer questions

31
Q

What is the mangement of depresision

A 
Talking therapies
Exercise and social prgrammes
Good sleep hygeine
Improved nutrition
Treat pain/co-morbidities
Review medication
32
Q

What is the pharmacological management of depression?

A

SSRIs e.g. citalopram or sertraline

SNRIs e.g. venlafaxine

Atypical e.g. mirtazapine (helps with sleep and appetite)

Avoid TCAs as they have anticholinergic effects

Year 3 Neuro (17 decks)

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