Dementia Flashcards

1
Q

what is dementia?

A

an acquired and persistent generalised disturbance of higher mental functions

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2
Q

what the 4 most common types of dementia?

A

alzheimers
levy body
fronto-temporal
vascular

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3
Q

what is the first part of the brain that is affected in Alzheimer’s?

A

nucleus basalis Meynert

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4
Q

how does vascular dementia usually present as?

A

cumulative effects of many strokes

sudden onset of stepwise deterioration

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5
Q

what is well preserved in vascular dementia and what will this eventually cause?

A

insight and judgement

depression

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6
Q

how does lewy body dementia present as?

A

fluctuating cognitive impairment
visual hallucinations
parkinsonism
REM sleep behavioural sleep disturbance

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7
Q

how does frontal-temporal dementia present as?

A

characteristic changes to personality

social deterioration leading to impairment of intellect, memory and language

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8
Q

what is the main cause of death in those who have dementia?

A

broncho-pneumonia

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9
Q

what genetic cause Alzheimer’s?

A

amyloid precursor protein - APP
presenilin 1+2
apoliporotein E allele E4

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10
Q

what does apoloporoprotein E allele E4 code for?

A

cholestrol transport protein

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11
Q

in what condition is APP also increased?

A

downs syndrome

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12
Q

what is the gross pathology of alzhiemers?

A

accumulation of beta-amyloid peptide
degenerative product of APP = neural damage

neurofibrillary tangles
increased amyloid plaques
loss of AcH - caused by accumulation of Tau protein

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13
Q

how is dementia diagnosed?

A

mental state examination
CT/MRI - vascular demential
cognitive testing

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14
Q

what is seen on macroscopic pathology?

A

cortical atrophy
widening of sulk
narrowing of gyri
dilatation of ventricles q

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15
Q

what is spared in alzheimers?

A

occipital lobe

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16
Q

what seen on microscopic pathology?

A

entensive neural loss with associated astrocyte proliferation

17
Q

what are lewy bodies?

A

alpha synuclein proteins

18
Q

how is dementia treated?

A

supportive

acytelocholinerase inhibitors

19
Q

what is an example of a acytelocholinerase inhibitor?

A

donepezil

20
Q

when is donepezil not used?

A

fronto-temporal dementia

21
Q

what is used in moderate/severe dementia?

A

memantine

22
Q

what is the MOA of memantine?

A

NMDA antagonist

23
Q

what is the most common complication of dementia?

A

depression