Dementia Flashcards
Pathology of dementia on an anatomical. Cellular, and biochemical level
76-2
Explain AD diagnosis to patient son
http://www.nhs.uk/Video/Pages/brain-tour-what-is-dementia.aspx?searchtype=Search&searchterm=Dementia+&offset=1&
Dementia definition
72-1
Dementia prevelance and age relationship
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
Dementia initial( l,i,a,d, ) and later sx ( l,a,h,b)
72-3
Dementia what problems it can cause for carers
72-4
Dementia what help patients need in later stages
72-5
Dementia common causes and less common causes
72-6
Dementia reversible causes
73-1
Dementia relationship between short term and long term memory
73-2
What inv to do in suspected dementia patients and why
74-2
How does dementia often presenet?
Where can GP refer suspected dementia patients?
75-1
AD sex incidence with age
- progression of disease sx
- duration of onset
75-2
AD aetiology
- genetic component?
- chromosome involved?
75-3
AD most important risk factor and other risk factors
76-1
AD pathology on an anatomical, cellular and biochemical level
76-2
AD diagnosis- what factors lead to diagnosis?
Significant Ct finding?
76-3
AD Tx
What is the doctors role
Who can you refer to?
76.4
AD drugs Generic and brand names Mechanism of action How long benefits last Are they used in vasc dementia? Why or why not
76-5
Vasc dementia definition and aetiology
77-1
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.
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.
Vasc dementia findings in the history
77-3
Vasc dementia examination findings and most important ix
77-4
Vasc dementia mgmt- u, s, a,a,s
77-5
