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Year 4: Psychiatry > Dementia > Flashcards

Dementia Flashcards

1
Q

what is dementia characterised by

A

global cognitive decline

- impaired memory, thinking, orientation, comprehension, language and judgement

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2
Q

common presenting complaints of memory problems

A 
forgetting a message/ peoples names/ faces
losing track of conversation 
forgetting to do things
inability to navigate in familiar places
increased misplacing of things
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3
Q

symptoms of dementia

A

global cognitive decline
mood disturbance
personality change
psychosis

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4
Q

routine bloods for people presenting with symptoms of dementia

A

FBC
thyroid function
serum B12/folate

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5
Q

screening test for dementia

A

MMSE

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6
Q

normal MMSE score

A

greater than 27 out of 30

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7
Q

MMSE score indicative of dementia

A

<24

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8
Q

most common type of dementia

A

alzheimers

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9
Q

where does alzheimers first affect in the brain

A

nucleus basalis of Meynert

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10
Q

what is special about the nucleus basalis of Meynert

A

main source of acetylcholine for the cortex

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11
Q

microscopic changes in alzheimers

A

intracytoplasmic neurofibrillary tangles
beta amyloid plaques
extensive neuronal loss with astrocytosis
amyloid antipathy

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12
Q

what are neurofibrillary tangles

A

abnormally phosphorylated tau protein

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13
Q

effects of beta amyloid plaques in Alzheimers

A

prevent synapses from transmitting acetylcholine

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14
Q

what genetic condition increases risk of Alzheimers

A

Down syndrome

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15
Q

other risk factors for Alzheimers

A

previous head injury
hypothyroid
parkinsons

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16
Q

how is the progression of Alzheimers described

A

stage 1
stage 2
stage 3

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17
Q

stage 1 Alzheimers symptoms

A

amnesia

spatial disorientation

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18
Q

stage 2 Alzheimers symptoms

A

personality change- aggression, agitation, psychosis, depression

dysphasia, apraxia

parkinsonism

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19
Q

stage 3 Alzheimers symptoms

A 
apathy 
wasting 
immobility 
incontinence
siezures 
spacisity
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20
Q

1st line treatment of Alzheimers

A

cholinesterase inhibitors

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21
Q

examples of cholinesterase inhibitors

A

galantamine
rivastigmine
donepezil

22
Q

side effects of cholinesterase inhibitors

A 
GI upset
tiredness
headache
bradycardia 
sleep disturbance
23
Q

2nd line treatment of Alzheimers

A

memantine 5mg

24
Q

mode of action of memantine

A

blocks NMDA receptors

25
Q

side effects of memantine

A

sedation

26
Q

which lobes are affected in Alzheimers

A

temporal- parietal

27
Q

what is used to differentiate between Alzheimers and vascular dementia

A

Hachinski score

28
Q

hachinksi score <4

what type of dementia ?

A

alzheimers

29
Q

hachinksi score >7

what type of dementia

A

vascular

30
Q

SPECT scan of vascular dementia

A

patchy uptake throughout

31
Q

risk factors for vascular dementia

A 
>60 years old 
obesity 
hypertension 
smoking 
vascular disease
32
Q

what is jaw jerk a sign of

A

frontal cognitive syndrome

33
Q

management of vascular dementia

A

maintain BP in normal range

antiplatelet (aspirin/ clopidogrel) + statin

34
Q

second most common type of dementia

A

dementia with lewy body

35
Q

what are lewy bodies

A

eosinophilic alpha synuclein protein cytoplasmic inclusions

36
Q

how can lewy bodies be detected

A

immunochemical staining for ubiquitin protein

37
Q

classical presentation of lewy body dementia

A

fluctuating symptoms of hallucinations, decline in cognition, gait abnormalities

38
Q

what can Lewy body dementia be confused with

A

dementia in parkinson disease

39
Q

difference between Lewy body + parkinson disease dementia

A

Lewy body- cognitive impairment occurs around the same time as movement disorder

dementia in parkinsons- movement disorder is present for at least a year before onset of cognitive decline

40
Q

what sleep disorder is seen in Lewy body dementia

A

REM sleep disorder

41
Q

what is picks disease

A

type of fronts-temporal dementia

onset 50-60years

42
Q

characteristics of picks disease

A

slow progression
changes in personality + social deterioration

impaired intellect, memory + language

43
Q

what are pick cells

A

swollen neurones

44
Q

what are picks bodies

A

intracytoplasmic filamentous inclusions

45
Q

effects of picks disease in the brain

A

extreme atrophy of frontal + temporal lobes

46
Q

diagnosis of alcohol related dementia

A

memory impairment + 1 of:

  • apraxia (can’t perform purposeful actions)
  • aphasia (inability to understand/ produce speech)
  • agnosia (inability to interpret sensations)
  • disturbance in executive function
  • function impairment
47
Q

pathology behind alcohol related dementia

A

thiamine deficiency

48
Q

triad of thiamine deficiency

A

confusion, ataxia, ophthalmoplegia

49
Q

what is ophthalmoplegia

A

paralysis of muscles around or in the eyes

50
Q

treatment of alcohol related dementia

A

thiamine

51
Q

anterograde amnesia

A

difficulty remembering new material + events since onset of illness/injury

52
Q

retrograde amnesia

A

difficulty remembering info prior to onset of the illness/injury

Year 4: Psychiatry (22 decks)

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