Dementia

Question 0

Pathology of dementia on an anatomical. Cellular, and biochemical level

Answer 0

76-2

Question 1

Explain AD diagnosis to patient son

Answer 1

http://www.nhs.uk/Video/Pages/brain-tour-what-is-dementia.aspx?searchtype=Search&searchterm=Dementia+&offset=1&

Question 2

Dementia definition

Answer 2

72-1

Question 3

Dementia prevelance and age relationship

Answer 3

The prevalence of dementia is below 1% in individuals aged 60-64 years, but shows an almost exponential increase with age, so that in people aged 85 years or older the prevalence is between 24% and 33% in the Western world.

(Ie up to 1 in 3 age 85)

72-2

Question 4

Dementia initial( l,i,a,d, ) and later sx ( l,a,h,b)

Answer 4

72-3

Question 5

Dementia what problems it can cause for carers

Answer 5

72-4

Question 6

Dementia what help patients need in later stages

Answer 6

72-5

Question 7

Dementia common causes and less common causes

Answer 7

72-6

Question 8

Dementia reversible causes

Answer 8

73-1

Question 9

Dementia relationship between short term and long term memory

Answer 9

73-2

Question 10

What inv to do in suspected dementia patients and why

Answer 10

74-2

Question 11

How does dementia often presenet?

Where can GP refer suspected dementia patients?

Answer 11

75-1

Question 12

AD sex incidence with age

• progression of disease sx
• duration of onset

Answer 12

75-2

Question 13

AD aetiology

• genetic component?
• chromosome involved?

Answer 13

75-3

Question 14

AD most important risk factor and other risk factors

Answer 14

76-1

Question 15

AD pathology on an anatomical, cellular and biochemical level

Answer 15

76-2

Question 16

AD diagnosis- what factors lead to diagnosis?

Significant Ct finding?

Answer 16

76-3

Question 17

AD Tx
What is the doctors role
Who can you refer to?

Answer 17

76.4

Question 18

AD drugs
Generic and brand names
Mechanism of action
How long benefits last
Are they used in vasc dementia? Why or why not

Answer 18

76-5

Question 19

Vasc dementia definition and aetiology

Answer 19

77-1

Question 20

Dementia osce from patient.co.uk

You are an FY2 in the memory clinic. John Smith (82 years old) has been brought by his daughter, Mary. He lives on his own - as his wife died last year - and Mary had become concerned about how he was coping on his own. He had become increasingly forgetful and his personal hygiene was noticeably worse.
After seeing his GP, who had asked a few questions and done some blood tests, he had been referred to the clinic. Based on testing here and at the GP surgery (and negative blood test results) your consultant feels that the most likely diagnosis is moderate Alzheimerʼs disease.
John has given his permission for you to talk to Mary. She would like to know what the problem is and what can be done to help.

Answer 20

Reveal Answer
This station tests your ability to break bad news (BBN) and your knowledge of Alzheimerʼs disease.

BBN should ideally be taught in a small group communication skills setting. The “SPIKES” protocol is useful and has been well validated.

S = Setting (quiet room, free of interruption or ʻbleepsʼ, body position, eye contact).
P = Perception (patient or carerʼs perception of current situation).
I = Invitation (does the patient or carer want to know now? Would later be better?).
K = Knowledge (what do they already know about this condition? Start at a place compatible with the patient’s current comprehension. Use small chunks. Use English not Medspeak. Acknowledge all patient’s responses and tailor delivery of information appropriately to patient’s responses.
E = Empathising and exploring (Acknowledge and validate their feelings).
S = Strategy and summary (make sure they have understood correctly. Make an acceptable plan).
Mary may well know quite a bit about Alzheimerʼs disease - it is common and well publicised. To perform well you will need to balance being factual (poor prognosis etc) with empathy and good listening.

As John has been assessed as having moderate Alzheimerʼs disease he will be eligible for treatment with acetylcholinesterase inhibitors and you should be able to outline what this means to John and how he will be monitored.

You could offer written information about the condition and this could contain useful contacts like The Alzheimer’s Society, to support Mary.

Social services and occupational therapy could assess Johnʼs ability to live independently and offer support where possible.

Question 21

Vasc dementia findings in the history

Answer 21

77-3

Question 22

Vasc dementia examination findings and most important ix

Answer 22

77-4

Question 23

Vasc dementia mgmt- u, s, a,a,s

Answer 23

77-5

Question 24

Dementia osce

Answer 24

2008 Osce pdf p1

Question 25

LEwy body dementia LBD definition and relationship to parkinsons and AD

Answer 25

77-6

Question 26

Describe onset, and progression of sx in LBD. Dewcribe assoc sx-, b,h,f

Answer 26

77-7

Question 27

Tx of LBD

What drugs to NEVER give in LBD and why?

Answer 27

78-1

Question 28

What considerations are three with dementia and driving?

What do you need to do with the DVLA?

Answer 28

78-2

Question 29

Dementia and mental capacity

Answer 29

78-3

Question 30

Why is mental capacity relevant to dementia?
How do you assess capacity?
How can capacity change?

Answer 30

78-3