Dementia Flashcards

1
Q

Symptoms of dementia?

A

memory loss
problems with reasoning/communication
Difficulty in making decisions
Dysphasia
Difficulty in coordinating movements e.g. dressing
Disorientation and unawareness of time/place
Difficulty with planning, judgement, loss of initiative and problem solving.

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2
Q

Behavioural and psychological symptoms?

A

psychosis
agitation and emotional liability
depression and anxiety
Disinhibition
Withdrawal or apathy
motor disturbance
sleep cycle disturbance/ insomnia
Tendency to repeat phrases or Qs
Difficulties with activities of daily living

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3
Q

Assessment for dementia?

A

Take history (from patient and also from family/friend)
- informant questionnaire on cognitive decline
Timescale of onset of symptoms & deterioration
acute
Physical examination including neurological signs
- coordination/gait problems
-sensory findings
-motor symptoms
Blood tests- assessing cognitive decline
Assess cognitive decline- 10 point cognitive screener

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4
Q

Risk factors for Dementia

A

Medication history
FH of dementia
Alcohol and drug use

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5
Q

Differential diagnosis

A

Age related decline
Mild cognitive impairment
depression
delirium
vitamin deficiency- thiamine, B12
Hypothyroidism
Adverse effects of medication

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6
Q

presenting symptoms specifically for Alzheimers

A

Loss of recent memory first + often difficulty without executive function &/or nominal dysphasia

Loss of episodic memory
Cognitive deficits - aphasia, apraxia and agnosia

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7
Q

presenting symptoms specifically for Vascular dementia

A

stepwise increase in severity of symptoms- subcortical ischaemic
focal neurological signs

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8
Q

presenting symptoms specifically for Dementia with Lewy bodies

A

-Core clinical feautures are fluctuating cognition- recurrent visual hallucinations
REM sleep behaviour disorder
1 + symptom of Parkinson’s

  • memory impairment may not be apparent in early stages
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9
Q

presenting symptoms specifically for Frontotemporal dementia

A

Personality change
behavioural disturbance
cognitive function may be relatively preserved

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10
Q

First line treatment of dementia?

A

Acetylcholinesterase (Ache inhibitors) as mono-therapy mild-moderate Alzheimers

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11
Q

If the patient has severe Alzheimers or is intolerant to general first line what medication should be given?

A

Memantine

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12
Q

What should be given for Non- Alzheimers Dementia?

A

Ache/ Memantine - unlicensed but can be used under specialist care

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13
Q

First line treatment for dementia with Lewy bodies and then if 1st line is not tolerated what should be given?

A

Donepezil or Rivastigamine - 1st line

If Don… or Riv…. not tolerated then Galantamine should be given

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14
Q

Vascular Dementia treatment?

A

AchE inhibitors or memantine

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15
Q

What drugs should patients with Frontotemporal dementia not be offered?

A

AchE inhibitors or memantine

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16
Q

Examples of Ache inhibitors

A

Donepezil, Galantamine and Rivastigamine

17
Q

Which organisation should be notified when a patient has either suspected or confirmed dementia?

A

DVLA