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Dementia Flashcards

1
Q

What is dementia?

A

a progressive and largely irreversible syndrome that is characterised by a widespread impairment of mental function

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2
Q

Disease o the medial temporal lobe, hippocampus, amygdala and limbic system lead to what?

A

disorders in memory and hallucinations

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3
Q

What is disease of the temporal neocortex associated with?

A

receptive dysphasia and automatisms

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4
Q

Disease of the parietal lobe leads to what?

A

impairment of visuospatial skills and integration of sensory inputs, leading to sensory agnosias and apraxias

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5
Q

What does disease of the frontal lobes lead to?

A

abnormalities in several behavioural domains - impairment of judgement, abstract reasoning, strategic planning, emotional restraint and control of appetite

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6
Q

What does disease of the occipital lobe lead to?

A

failure of visual sensory systems

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7
Q

Name 4 types of neurodegenerative dementias

A
  • Alzheimer’s
  • Lewy Body
  • Frontotemporal
  • Huntington’s disease
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8
Q

Which type of neurodegenerative dementia is Parkinson’s disease associated with?

A

Lewy body dementia

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9
Q

Can treatment cure vascular dementia?

A

no, but treatment can slow down progression

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10
Q

How quickly does prion disease progress?

A

rapid progression (untreatable) - patients often die within 2-3 months of presentation

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11
Q

What are the classic presentations of cortical dementia?

A

higher cortical abnormalities - dysphasia, agnosia, apraxia

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12
Q

Is Alzheimer’s cortical or sub-cortical?

A

cortical

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13
Q

How would subcortical dementia classically present?

A

apathetic, forgetful and slow, associated with other neurological signs and movement disorders

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14
Q

Which neurodegenerative diseases are associated with synucleinopathies?

A
  • Parkinson’s disease
  • Dementia with Lewy Bodies
  • MSA
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15
Q

Which neurodegenerative diseases are associated with ubiqionopathies?

A
  • MND and MND/dementia

- semantic dementia

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16
Q

What is the triad of symptoms presenting in normal pressure hydrocephalus?

A
  1. dementia
  2. gait disturbance
  3. urinary incontinence
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17
Q

How does transmissible spongiform encephalopathies present under a microscope?

A

tissue looks like a sponge

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18
Q

What would be noticeable in an MRI of someone with sporadic CJD?

A

non-specific changes in basal ganglia

19
Q

What is the characteristic EEG in a patient with CJD?

A

triphasic waves on repeat testing

20
Q

What is a ‘pulvinar sign’?

A

characteristic abnormality seen in the posterior thalamic region

21
Q

What disease is a pulvinar sign highly sensitive and specific for?

A

variant CJD

22
Q

What would you use to treat autoimmune encephalitis?

A

steroids

23
Q

Define cognition

A

sum of brain function which allows us to integrate in the environment

24
Q

What are amyloid proteins?

A

insoluble fibrous proteins aggregates sharing specific structural traits

25
Q

What are tau proteins?

A

a group of proteins that stabilise microtubules in neurons

26
Q

How many isoforms of tau proteins are there?>

A

6

27
Q

What is ubiquitin?

A

a small regulatory protein that has been found in almost all cells of eukaryotic organisms

28
Q

What is the function of ubiquitin?

A

directs proteins to compartments in the cells and can attach to proteins and label them for destruction

29
Q

What is the function of the limbic system?

A

arousal, emotion, motivation, attention and memory

30
Q

Describe a simple microcircuit in the brain

A

neuron > synapse > neurotransmitter > action potential

31
Q

What are the two functional classifications of neurodegenerative disorders?

A

cognitive (AD) and movement (PD)

32
Q

which protein can produce Lewy bodies when mutated?

A

alpha-synuclein

33
Q

What is oxidative stress?

A

imbalance in cell due to excess oxygen free radicals (causes neuronal cell death)

34
Q

what is a normal brain weight? What would you expect in someone with AD?

A

1200-1400 g

AD: 900-1100g

35
Q

In which areas would you expect to see most atrophy in the brain in AD?

A
  • hippocampus
  • temporal lobe
  • parietal lobe
  • frontal lobe
  • cingulate gyrus
36
Q

what does atrophy in deep white matter cause?

A

ventricular dilation

37
Q

What skills will someone lose in significant hippocampal atrophy?

A

inability to learn new things and to retain new facts

38
Q

Do tangles or plaques show correlation to clinical severity?

A

tangles

39
Q

How many Braak and Braak stages are there?

A

6

40
Q

Where would the most significant atrophy be seen in dementia with Lewy body?

A

amygdala, cingulate gyrus, temporal, parietal and frontal lobes

41
Q

What is the most striking feature seen in a brain with Lewy bodies?

A

pale substantia nigra

42
Q

What is the pathology of Binswanger’s disease?

A

blood vessels cause microinfarction of the white matter

43
Q

What is Pick’s disease?

A

frontotemporal dementia

44
Q

In Pick’s disease, what would you expect to see under the microscope?

A

ballooned neurones due to them being tau +ve and ubiquitin +ve

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