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Psychiatry > Dementia > Flashcards

Dementia Flashcards

1
Q

What is Lewy body dementia

A

Depositions of abnormal proteins called Lewy bodies in brain cells

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2
Q

Course of lewy body dementia

A

Fluctuating course

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3
Q

Symptoms and signs of lewy body dementia

A

Global brain dysfunction, visual hallucinations, parkinsonian signs

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4
Q

Areas of brain affected in lewy body dementia

A

Alpha-synuclein cytoplasmic inclusions in substantia nigra, paralimbic and neocortical areas

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5
Q

Treatment of lewy body dementia

A

Cholinesterase inhibitors, dopamine replacement, avoiding antipsychotics

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6
Q

Symptoms of frontotemporal dementia

A

Language, personality and behavioural changes and disorders

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7
Q

Cause of frontotemporal dementia

A

Severe atrophy of frontal and temporal lobes

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8
Q

Diagnosis of frontotemporal dementia

A

Microscopy shows severe neuronal loss and gliosis, abnormal protein aggregates

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9
Q

Onset of frontotemporal dementia

A

Earlier age onset of >35 years

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10
Q

Risk of vascular dementia

A

Stroke, vascular disease, atherosclerosis of arteries

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11
Q

Time course of vascular dementia

A

Acute cognitive decline in step-wise course from cerebro-vascular events

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12
Q

Causes of multifactorial vascular dementia

A

Multiple infarcts producing deterioration, infarcts primarily in white matter.

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13
Q

Associations with subcortical vascular dementia

A

Small vessel disease, lacunes in basal ganglia, can be small cavitating lesions, small infarcts or enlarged perivascular spaces

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14
Q

Treatment of vascular dementia

A

Prophylaxis against cerebral emboli with aspirin/warfarin. Control of HTN, and can use AchEI or memantidine

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15
Q

What is dementia

A

Group of chronic progressing signs and symptoms involving multiple higher cortical functions such as memory, orientation, thinking, language and comprehension

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16
Q

Types and prevalence of dementia

A

Alzheimer’s - 70%
Dementia with Lewy bodies
Vascular dementia
Frontotemporal dementia
Others such as Huntingtons, Wernickes. CJD

17
Q

Diagnosis of dementia

A

History, cognitive testing, MMSE, MOCA, biomarkers, brainscans, bloods, DNA and CSF

18
Q

Clinical features of Alzheimer’s

A

Amnesia, aphasia, agnosia, apraxia

19
Q

Brain pathology in Alz

A

Enlarged and wider asymmetrical ventricles from atrophy, no well defined cortex, gyri widen, sulci have gaps, atrophy of hippocampus, frontal and temporal lobes

20
Q

Proteins deposits in Alz

A

Amyloid protein plaques deposited around neurons and tau proteins tangle within brain

21
Q

Genetic causes of Alz

A

Autosomal dominant and sporadic

22
Q

Autosomal dominant causes of Alz

A

<65, early onset AD, frontotemporal and huntingtons

23
Q

Sporadic causes of Alz

A

> 65 years, late onset AD, dementia with lewy bodies

24
Q

Drug options for Alz

A

Anticholinesterases - Donepezil, Galantamine, Rivastigmine. NMDA receptor antagonists - Memantine

25
Q

When are anticholinesterases used

A

Given in mild-moderate AD to temporarily improve cognitive function in early stages. Increase cholinergic transmission

26
Q

Side effects of AChEI

A

Anorexia, nausea, vomiting, diarrhoea, abdo pain, hallucinations, drowsiness, agitation, dizziness, insomnia, headache, bradycardia

27
Q

Use of NMDA antagonists

A

With AChEI in moderate AD or severe AD, or if intolerant to AChEI.

28
Q

Side effects of NMDA antagonists

A

Constipation, ehadache, dizziness, drowsiness, HTN, dysopnoea

29
Q

Cause of Huntington’s disease

A

Inherited autosomal dominant disorder, usually presenting at 50. Repeats of CAG trinucleotide, more repeats coresponds to earlier onset

30
Q

Symptoms of Huntington’s disease

A

Personality change, depression, dementia, choreoathertosis, jerky movements

31
Q

Diagnosis of Huntington’s

A

Genetic testing, loss of striatal volume, increased size of frontal horns in lateral ventricles on CT/MRI. Intranuclear aggregates of prtoein

32
Q

Treatment of Huntington’s

A

Treat psychosis, depression, chorea. No treatment to stop progression of disability

33
Q

Prognosis of Huntington’s

A

After diagnosis patients can live from 5 - 30 years

Psychiatry (15 decks)

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