Dementia

Question 1

Diagnostic criteria of dementia. What is early onset?

Answer 1

Early onset 65-

Memory, Aphasia, Apraxia, Agnosia, Personality changes, Hallucinations, Depression, Delusions, Seizures

Question 2

How does AD present. Etiology. Treatment. investigation

Answer 2

presents with gradual progressive cognitive decline
Etiology - reduced ACh due to degeneration of cholinergic neurones. Phosphorylation of Tau causing neurofibrillary tangles. Formation of extracellular beta amyloid plaques.
Investigation - CT generaised atrophy with widened sulci and enlarged ventricles
Treatment - AChesterase inhibitors eg donepezil, galantamine. Antags of NMDARs eg Memantine

Question 3

vascular dementia presentation, etiology and management and investigation

Answer 3

present - CVA evidence. Deterioration in cognitive function
Etiology - multiple infarcts
investigation - CT head shows small vessel disease with infarcts
Manage - Reduce risks eg statins

Question 4

Lewy body dementia presentation, etiology, and management and investigation

Answer 4

presentation - day to day fluctuations in cognitive performance. Visual hallucinations. Parkinsonism.
Etiology - abnormally phosphorylated proteins aggregated with UBQ and alpha-synuclein
investigation - DAT scan shows less dopamine
Treatment - AChesterase inhibs. Dopamine agonists eg levodops for motor symptoms.

Question 5

Frontotemporal dementia presentation,investigation, treatment

Answer 5

Presents - decline in social and personal conduct. Emotional blunting. Echolalia, mutism, lack of insight. Cognitive sparing
investigation - Bilateral atrophy of frontal and temporal lobes
Treatment - SSRIs

Question 6

Pseudodementia presentation and treatment

Answer 6

Reversible and due to depression. Treat with SSRIs

Question 7

Normal pressure hydrocephalus symptoms

Answer 7

triad of symptoms - urinary incontinence, bradykinesia, memory loss