dementia

Question 1

Alzheimer’s dementia

Answer 1

brain atrophy, amyloid plaques, reduced cholinergic activity

Question 2

vascular dementia

Answer 2

vascular damage and impaired blood supply
risk is HTN, diabetes, smoking

Question 3

lewy body dementia

Answer 3

progressive cognitive decline, visual hallucinations, delusions, parkinsonism

Question 4

frontotemporal dementia

Answer 4

starts younger age, behaviour, language, speech

Question 5

differentials for dementia

Answer 5

drug induced eg anticholinergic eg oxybutynin
depression
psychosis
delerium
brain tumour eg in frontal lobe
parkinsons
huntingtons
progressive supranuclear palsy
hypothyroid
cushings
hypercalcaemia
b12 deficiency
thiamine deficiency

Question 6

dementia modifiable risk

Answer 6

exercise, mental stimulation, healthy weight, bp control, glucose control

Question 7

presentation for dementia

Answer 7

forgetting things
repeatedly asking the same question
impaired decision making
reduced flexibility

Question 8

features of advanced dementia

Answer 8

aphasia
dysphagia
appetite and weight loss
incontinence

Question 9

Investigations in dementia

Answer 9

FBC U+E LFT CRP TFT calcium HBA1C
B12 folate MSU CXR

Question 10

Test for dementia

Answer 10

ACE-III
attention
memory
language
visuospatial
verbal fluency

Question 11

Management of dementia

Answer 11

LPA
advanced decision
future care planning
rivastigmine Acetylcholinesterase inhibitors
memantine NMDA blocker

Question 12

behavioural and psychological symptoms of dementia

and treatment

Answer 12

depression
anxiety
agitation
aggression
disinhibition
hallucinations
delusions
sleep disturbance
SSRI
risperidone
benzo for crisis