Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

54 CNS > Dementia > Flashcards

Dementia Flashcards

1
Q

DSM-5 criteria (A)

A

Significant cognitive decline in 1 or more cognitive domain:
- Learning and memory
- Language
- Executive function
- Complex attention
- Perceptual-motor
- Social cognition

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

DSM-5 criteria (B)

A

The cognitive deficits interfere with independence in everyday activities.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

DSM-5 criteria (C)

A

The cognitive deficits do not occur exclusively in the context of a delirium.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

DSM-5 criteria (D)

A

The cognitive deficits are not better explained by another mental disorder.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Areas of manifestation of dementia

A

Cognitive
Psychological
Behavioural
Sleep
Physical

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

MMSE score for mild AD

A

20-24 (out of 30)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

MMSE score for moderate AD

A

10-19 (out of 30)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

MMSE score for severe AD

A

<10 (out of 30)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

MMSE score for severe AD

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Types of dementia

A
  1. AD
  2. Vascular dementia
  3. Lewy body dementia
  4. Frontotemporal dementia
  5. Mixed type
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Modifiable risk factors

A
  1. Age (5-10% >65y/o, 50% >85y/o)
  2. Female
  3. Ethnicity: black, Hispanic
  4. Genetics: APOE*4
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Non-modifiable risk factors

A
  1. HTN
  2. DM
  3. Binge drinking
  4. Smoking
  5. Limited physical activity
  6. Obesity
  7. Hearing loss
  8. Depression
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Clinical evaluations

A
  • Medical history (both patient and family/friend/caregiver)
  • Functional deficits
  • Cognitive deficits
  • Absence of alternative conditions
  • Labs (not routine)
  • Imaging (adjunct)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Laboratory testing (rule out)

A

Thyroid & Vitamin B12

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Structural brain imaging (AD)

A

Generalised or focal cortical atrophy, often asymmetrical

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Structural brain imaging (vascular)

A

Brain infarcts or white matter lesion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Structural brain imaging (frontotemporal)

A

Frontal lobe or anterior temporal lbe atrophy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Structural brain imaging (others)

A

Brain mass (tumour), hydrocephalus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

MoCA scoring (mild)

A

18-25

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

MoCA scoring (moderate)

A

10-17

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

MoCA scoring (severe)

A

<10

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Pathophysiology of AD

A
  1. Senile plagues
  2. Neurofibillary tangles (NFTs)
  3. Cholinergic deficits
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Major constituent of senile plaques

A

Aggregates of b-amyloid peptide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

How is Ab peptides derived?

A

Cleavage of amyloid precursor proteins (APP) via action of b- and γ-secretases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What is the alternative pathway of Ab peptides?

A

a- and γ- secretases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Major constituent of NFTs

A

Hyper-phophorylated tau protein aggregates forming paired helical filaments (PHF)

27
Q

What are tau?

A

Tubulin associated protein for microtubule stabilisation & intracellular transport

28
Q

Goals of AD management

A
  1. Slow progression
  2. Disease modifying (not available)
  3. Delay institutionalisation
    - Support & education for caregivers
    - Manage behavioural problems
29
Q

What are the commonly used anti-cholinesterase inhibitors?

A
  1. Donepezil
  2. Galantamine
  3. Rivastigamine
30
Q

MOA of AIs

A

Inhibits acetylcholinesterase enzyme from breaking down EACh, increasing duration and level of EACh at the synaptic cleft for cholinergic neurotransmission

31
Q

How long should AIs be titrated to reach target dose and minimise AEs?

A

4-8 weeks

32
Q

Side effects of AIs

A

Cholinergic hyper activation: N?V, diarrhoea

33
Q

Less common side effects of AIs

A

Muscle cramp
Bradycardia
Loss of appetite
Increased gastric juice secretion

34
Q

Initial dose of Donepezil

A

5mg OD in the evening (oral)
5mg/day weekly (patch)

35
Q

Usual range of Donepezil

A

5-10mg (mild-moderate)
10-23mg (moderate-severe)

36
Q

Dosage adjustment - Donepezil

A

No adjustment required

37
Q

Initial dose of Rivastigmine

A

1.5mg BD (oral)
4.6mg/day (patch)

38
Q

Usual range of Rivastigmine

A

3-6mg OD (oral)
9.5-13.3 mg/day (patch)

39
Q

Rivastigmine metabolism

A

Renal

40
Q

Dosage adjustment - Rivastigmine

A

Renal, hepatic, low body weight - consider lower dose

41
Q

Initial dose of Galantamine

A

4mg OD (oral)
8mg OM (ER)

42
Q

Usual range of Galantamine

A

8-12mg BD (oral)
16-24mg OD (ER)

43
Q

Dosage adjustment - Galantamine

A

Moderate renal/hepatic impairment: max daily = 16mg
Not recommended for severe renal/hepatic impairment

44
Q

Efficacy monitoring of AIs

A

Day to day life improvement

45
Q

Non-pharmacological 1

A

Cognitively stimulating activities (reading, games)

46
Q

Non-pharmacological 2

A

Physical exercise (aerobic and anaerobic)

47
Q

Non-pharmacological 3

A

Social interactions with others (family events)

48
Q

Non-pharmacological 4

A

Healthy diet such as Mediterranean diet

49
Q

Non-pharmacological 5

A

Adequate sleep (uninterrupted sleep and with sufficient number of hours)

50
Q

Non-pharmacological 6

A

Proper personal hygiene (regular bathing)

51
Q

Non-pharmacological 7

A

Safety, including inside the home and outside

52
Q

Non-pharmacological 8

A

Medical and advanced care directives (designation of lasting power of attorney)

53
Q

Non-pharmacological 9

A

Long term health care planning

54
Q

Non-pharmacological 10

A

Financial planning

55
Q

Non-pharmacological 11

A

Effective communication

56
Q

Non-pharmacological 12

A

Psychological health (participating in personally meaningful activities such as playing music)

57
Q

BPSD 1

A

Agitation & aggression

58
Q

BPSD 2

A

Depression

59
Q

BPSD 3

A

Anxiety

60
Q

BPSD 4

A

Apathy

61
Q

BPSD 5

A

Psychotic symptoms

62
Q

BPSD 6

A

Wandering

63
Q

BPSD 7

A

Nocturnal disruption

54 CNS (13 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions