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Exam theory > Dementia > Flashcards

Dementia Flashcards

1
Q

How is normal pressure hydrocephalus (NPH) characterised?

A

By early onset of gait abnormality with little or no cortical atrophy on neuroimaging studies

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2
Q

Diagnosis and Statistical Manual of mental disorders (DSM)
- 4 A’s of impairment of at least one higher cortical function

A

Aphasia
Agnosia
Apraxia
Abstraction of judgement

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3
Q

Associated issues with dementia

A
  • Depression
  • Cognitive training
  • Mobility
  • Behaviour/aggression
  • Advocacy
  • Hospitalisation and residential care
  • Continence
  • Pain
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4
Q

Depression is common to co-exist with dementia. What would the benefits of resolving this issue have for the paitent?

A

Resolution of depression can improve cognitive function.

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5
Q

What type of treatment can be used for mild to moderate dementia?

A

CST- cognitive stimulation therapy

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6
Q

Benefits of exercise for dementia?

A

Can delay onset/progession of dementia
Decrease risk of falls or strength loss
Improve function in ADL’s (active daily living)

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7
Q

The exact cause of NPH is unknown, but it is correlated with the following:

A
  • meningitis,
  • head trauma,
  • subarachnoid hemorrhage,
  • Paget’s disease of the skull,
  • Mucopolysaccharidosis of the meninges.
  • Systemic hypertension.
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8
Q

What was the first sign of normal pressure hydrocephalus (NPH) when discovered in 1965, and is also typically the earliest feature noted, and considered to be the most reponsive to treatment?

A

gait abnormalites

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9
Q

Cardinal signs required for a diagnosis of parkinsons disease

A

distal resting tremor of 3-6 Hz
rigidity
bradykinesia
asymmetrical onset

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10
Q

What is a common symptom of parkinson’s disease?

A

Reversal of sleep cycle

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11
Q

The most common cause of dementia

A

Alzheimer’s Disease

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12
Q

What are some common risk factors that increase the risk for developing alzheimers disease?

A

Positive Family History
Down Syndrome

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13
Q

Finish this sentence. “Paitents with Alzheimer’s disease commonly present with…”

A

An insideous onset of memory loss which slowly progresses over many years

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14
Q

Clinical History of Alzheimers disease

A
  • Episodic memory +/- difficult learning new information
  • Communication
  • Mobility
  • Other symptoms throughout
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15
Q

Risk Factors for dementia

A
  • Age
  • Genetics
  • Smoking
  • Alcohol use
  • Atherosclerosis
  • Diabetes
  • Mild cognitive impairment
  • Down syndrome
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16
Q

Types of dementia

A
  • Alzheimer’s disease – MC, of all dementias.
  • Vascular dementia
  • Combination of which is called “mixed dementias”.
  • Parkinson’s Disease
17
Q

What type of dementia can occur with AD?

A

Vascular dementia

18
Q

Steps for differential diagnosis for dementia

A
  • Clinical Presentation- Carer feedback can be important
  • Cognitive assessment *-> MMSE, MiniCog, CDT *
  • Diagnosis by exclusion
19
Q

Signs of early dementia

A

Anomia - Difficulty find words to say
Agnosia - cannot recognise objects/people
Apraxia - inability to execute voluntary motor movement
Forgetting names, appt, done task, loosing things
Difficult performing familiar tasks
personality changes

20
Q

Anomia

A

Difficulty find words to say

21
Q

Agnosia

A

Cannot recognise objects or people despite previous knowledge

22
Q

Apraxia

A

inability to execute voluntary motor movement

23
Q

Signs of early dementia

A
  • Anomia - words
  • Agnosia - objects
  • Apraxia - mobilty
  • Forgetting names, tasks etc
  • Personality changes
24
Q

Signs of Intermediate dementia

A

Worsening of early signs
need help with ADL’s
disrupted sleep
difficulty learning new things
confusion/disorientation familiar surroundings
increased risk of falls from poor judgement

25
Q

Signs of severe dementia

A

worsened previous symptoms
complete ADL dependence
unable to walk/move without assistance
impaired swalling, malnutrition, choking, aspiration
complete loss of short or long memory
other complications i.e dehydration, bladder control, pressure sores

26
Q

Quantifying cognitive impairement with MMSE

A
  • Orientation (place and time)
  • Attention & calculation
  • Registration and recall
  • Construction
  • Language
  • 0-13= severe impairment
  • 14-20= moderate
  • 21-24= mild
  • 25-30= normal range
27
Q

Quantifying cognitive impairement with MiniCog

A

Clock draw CDT + 3 word recall

  • Recall 1-2 + abnormal clock = impaired
  • Recall 0 = impaired
28
Q

Medical management of dementia

A
  • Varies depending on diagnosis
  • Treat cause if possible
    -> Relieve and slow down the progress of symptoms, behaviour changes, and complication
    -> Minimise risk factors
    ->Treat co-morbidities
  • Healthy lifestyle
  • Symptom management
  • Carer support
29
Q

Rehabilitative strategies and interventions for dementia

A
  1. Guiding principles
  2. Recall strategies (mnmonics etc)
  3. Specific interventions
    (face-name, number, story, lists, procedural…)
30
Q

How can the issues associated with dementia be managed?

A
  • Treat Co-morbidities
  • Promote mobility
    (education, planning, physical support, assist desire movements)

Exam theory (9 decks)

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