Dementia

Question 1

Risk factors for Alzheimer’s

Answer 1

Age
MCI
Family hx
ApoE4 mutation

Question 2

2 cortical causes of dementia

2 mixed causes

Answer 2

Cortical - Alzheimer’s and frontotemporal dementia

Mixed (cortical + sub cortical)

Question 3

Disease features and progression of Alzheimer’s

Answer 3

Most common presenting symptoms is short term memory loss

Smooth slow decline

Question 4

Pathophys of Alzheimer’s

Answer 4

Accumulation of amyloid plaques and neurofibrillary tangles of tau protein

Question 5

Vascular dementia -

Disease course and features

Answer 5

Suspect when abrupt change or stepwise progression (especially with hx of cerebral infarct)

Mood disturbance and disorders, as well as gait disorders present

Question 6

Pathophys of levy body dementia

Answer 6

Global deposition of levy bodies (accumulation of alpha synuclein)

Question 7

Disease features in levy body dementia

Answer 7

Multitasking and complex cognitive function often primary issue

Early visuospatial and xecutive decline.

Visual hallucinations and falls!

Question 8

What type of dementia is picks disease

Answer 8

Frontotemporal dementia

Question 9

Frontotemporal dementia disease features

Answer 9

Prominent behavioural change

Dysphasia / dysphasia

Question 10

Most essential blood tests for dementia

Answer 10

B12, TFT, neuro imaging

Question 11

Differentials for dementia

Answer 11

Structural lesion - bleed or tumour

Depression

Alcoholism

Normal pressure hydrocephalus

Question 12

What drug class can potentially be used in dementia

Answer 12

Cholinesterase inhibitors- donepezil, rivastigmine, galantamine)

Question 13

What drugs can be used if acetylcholinesterase inhibitors don’t work

Answer 13

Memantine- NMDA receptor antagonist