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dementia Flashcards

1
Q

what age is classed as early onset alzheimers

A

<65

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2
Q

how is beta amyloid produced

A

cleavage of APP

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3
Q

what is a lewy body

A

intracytoplamic eosinophiic inclusion with dense core surrounded by alpha-synuclein fibrils

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4
Q

what atrophys first in huntingtons disease

A

basal ganglia - partic caudate nucelus

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5
Q

micropathophysiology in huntingtons

A

degen of striatal nucelus - l oss of inhibitory regulatory of motor activity

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6
Q

what are pick cells and picks bodies and when are they seen

A

cells = swollen neurons seen in frontotemporal dementia
bodies = intracytoplasmic filamentous inclusions

seen in frontotemporal dementia (picks disease)

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7
Q

Focal gyral atrophy with a knife-blade appearance is characteristic of what dementia

A

picks disease

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8
Q

what lobes atrophy in picks

A

frontal first and temporal

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9
Q

what happens in transient global amnesia

A

transient (4-6 hours) abrupt onset anterograde amnesia - cant make new memeories

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10
Q

treatment of myathenic crisis

A

plasmaphoresis
IVIG

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11
Q

symptoms of temporal lobe seizure

A

A sudden sense of unprovoked fear or joy
A deja vu experience — a feeling that what’s happening has happened before
A sudden or strange odor or taste
A rising sensation in the abdomen, similar to being on a roller coaster

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12
Q

in what dementia may cognition be fluctuating

A

lewy body

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13
Q

treatment of lewy body dementia

A

anti cholinesterase inhibitors

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14
Q

dx of lewy body

A

clinical
DAT/SPECT

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15
Q

what casues CJD

A

prion proteins

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16
Q

features of CJD

A

rapid onset dementis
myoclonus

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17
Q

investigations in CJD

A

CSF
EEG
MRI

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18
Q

most common CJD

A

sporadic

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19
Q

what causes variant CJD

A

eating meat form a cow with
mad cow- bovine spongiform encephalopathy

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20
Q

what is the hallmark of CJD

A

spongiform change

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21
Q

mean feature of posterior cortical atrophy

A

visual agnosia - man who thought wife was a hat
terry pratchett

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22
Q

features in primary prgoressive aphasia

A

semantic (naming memory) - language goes first

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23
Q

what mmse score indicates dementia

A

<24

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24
Q

what NCIE recommended scoring systems are used for dementia and score

A

10-CS 0-5 =cog impair

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25
Q

what test is used to assess delirium and score is indicitive

A

4AT and >4

26
Q

what blood tests are doen in dementia

A

FBC
U&E
LFT
TFT
B12/folate
Calcium
Glucose
ESR/CRP

27
Q

first line sedative in delirium

A

0.5mg haloperidol

28
Q

treatment of delirium in parkansonian patients

A

reduce parkinson meds or olanzapine

29
Q

management of severe alzheimers

A

memantine

30
Q

first line option is alzheimers

A

acetylcholinesterase inhibs
donepezil
rivastigmine
galantamine

31
Q

when is donepezil contraindicated

A

in patients with bradycardia

32
Q

how many mediations is classed as polypharmacy

A

4+

33
Q

what type of dementia shows fluctuating cognition

A

lewy body

34
Q

what questionnarie is used for frailty

A

PRISMA-7

35
Q

for non cell cycle secific antibiotics what is more important dose or duration

A

dose

36
Q

side effect of cisplatin

A

ototoxicity
nephrotoxicity
peripheral neuropathy
hypomagneium

37
Q

side effects of vincrsitine

A

peripheral neuropathy

38
Q

side effects of cyclophosphamide

A

haemorrhagic cystitis
myelosuppresion
bladder cancer

39
Q

management of neoplastic spinal cord comrpession

A

dexamethasone

40
Q

what cancer is most commonly associated with superior vena cava compression

A

lung

41
Q

features of SVC compression

A

dyspnoea is the most common symptom
swelling of the face, neck and arms - conjunctival and periorbital oedema may be seen
headache: often worse in the mornings
visual disturbance
pulseless jugular venous distension

42
Q

tumour marker for breast cancer

A

CA 15-3

43
Q

tumour marker forr colorectal cancer

A

carcinoembronic antigen (CEA)

44
Q

treatment for agitation in pallative care

A

haloperidol
midazolam in terminal phase

45
Q

tx of hiccups in palliative care

A

chlorpromazine

46
Q

empirical anti emetic in palliative care

A

metoclopramide

47
Q

in chemically mediated nausea in palliative care what is used

A

ondansetron, haloperidol and levomepromazine

48
Q

what should be given for palliative nausea in cerebral mets

A

cyclizine and dex

49
Q

palliative nausea TX in vestibular symtpoms

A

cyclizine

50
Q

in palliative care in cortical nausea- due to anxiety, pain, fear and/or anticipatory nausea what anti-emetic should be given

A

benzos
if not cyclizine

51
Q

what route should be taken for palliative care anti emetics if oral not available

A

parenteral

52
Q

example of pain regime in palliative care

A

20-30 mg MR morphine and 5mg breakthrough morphine

GIVE LAXATIVE - nausea and drowsy should be transient

53
Q

what ratio of morphine is breakthrough compared to daily dose

A

one sixth eg 5mg for 30mg

54
Q

what pain medication is given in palliative care in mild renal impairement

A

oxycodone

55
Q

what palliative care medication is given in severe renal imapirement

A

alfentanil, fentanyl, buprenorphine

56
Q

how much can you increase an opiate dose by

A

30-50%

57
Q

if switching codeine/tramadol to morphine what should you do to dose

A

divide by 10

58
Q

when switching oral morphine to oral oxycodoe what should you do to the dose

A

divide by 1.5/2

59
Q

what shoudl you do to dose when switching oral morphine to subcut

A

half it

60
Q

palliative treatment of secretions

A

hyoscine

61
Q

conversion of oral morphine to sucut diamorphine

A

divide by 3

62
Q

blood screen in demetia patient

A

FBC, U&E, LFTs, calcium, glucose, ESR/CRP, TFTs, vitamin B12 and folate levels

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