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Psychiatry > Dementia > Flashcards

Dementia Flashcards

1
Q

what can FAB (frontal-assessment battery) test distinguish between?

A

Fronto-temporal dementia + Alzheimer’s dementia

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2
Q

Alzheimer’s dementia is…

A

a progressive degenerative disease of the brain, accounting for the majority of dementia seen in the UK

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3
Q

How is cognitive testing important in the diagnosis of Dementia?

A

differentiates between the different types of dementia

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4
Q

name 3 cognitive function test and mood disorder scales that can be used

A
  1. FAB test = Frontal lobe Assessment Battery
  2. MMSE = mini mental state examination
  3. MoCA = Montreal Cognitive assessment
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5
Q

findings on MRI scan in Alzheimer’s dementia

A

Bilateral atrophy of temporal lobes + generalised atrophy

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6
Q

3 instruments to assess functional symptoms

A
  • activities of daily living questionnaire
  • functional activities questionnaire
  • bristol functional assessment
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7
Q

2 instruments to assess psychological symptoms

A
  • BRHAVE-AD

- Neuropsychiatric inventatory

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8
Q

1 instrument to assess care-giver strain

A

MBRC caregiver strain instrument

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9
Q

2 main subtypes of dementia

A

subcortical + cortical

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10
Q

3 types of cortical Dementia

A
  1. Alzheimer’s dementia
  2. Lewy Body dementia/Parkinson’s dementia
  3. Fronto-temporal dementia
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11
Q

3 types of Subcortical dementia

A
  1. Vascular dementia
  2. Alcohol related dementia
  3. Parkinson’s dementia
  4. Huntington’s dementia
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12
Q

Role of anterior + inferior temporal lobes?

A

semantic memory

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13
Q

Role of lateral temporal lobe?

A

Wernicke’s area

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14
Q

Role of medial temporal lobe?

A

Hippocampus: forming memories + anterograde amnesia

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15
Q

3 features Dementia is marked by?

A
  1. Impaired reasoning
  2. Personality changes
  3. Memory disorders
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16
Q

most common type of dementia?

A

Alzheimer’s dementia

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17
Q

2nd most common type of dementia

A

vascular dementia

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18
Q

Alzhemer’s dementia is more common in males/females

A

females

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19
Q

Vascular dementia is more common in males/females

A

males

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20
Q

Lewy Body dementia is more common in males/females

A

no difference between genders

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21
Q

risk factors for Dementia

A
  • depression in mid-life/later-life
  • head injuries in Parkinson’s dementia
  • lifestyle factors; smoking, alcohol, exercise, education
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22
Q

what ages are early + late onset Alzheimer’s dementia defined by

A

early onset = < 65 years old (30-60)

late onset = > 65 years old

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23
Q

3 exclusion criteria for Dementia

A
  1. absence of dementia
  2. symptoms present > 6 months
  3. Irreversible
24
Q

3 genes identified for Early onset Alzheimer’s dementia

A
  1. Amyloid precursor protein (on chromosome 21)
  2. Presenilin 1 (on chromosome 14)
  3. Presenilin 2 (on chromosome 1)
25
Q

inheritance pattern of the genes in Alzheimer’s dementia, and what are these genes involved in?

A

autosomal dominant

metabolism of amyloid protein

26
Q

gene identified for Late onset Alzheimer’s dementia

A

ApoE = Apolipoprotein E

occurs in 3 different alleles

27
Q

pathophysiology of Alzhemer’s dementia

A

loss of anticholinergic activity

28
Q

2 characteristic pathological changes in AD

A
  1. Beta amyloid plaques between neurones

2. Neurofibrillary tangles of hypophosphorylated tau inside neurones

29
Q

3 A’s of cortical dysfunction

A

A - Aphasia
A - Agnosia
A - Apraxia

30
Q

gene linked to Vascular dementia in rare cases?

A

NOTCH3 on chromosome 19

31
Q

7 risk factors for VD

A
  • obesity
  • smoking
  • previous stroke
  • AF
  • hx MI
  • raised cholesterol
  • DM
32
Q

symptoms of small vessel disease affecting the sub-cortex

A
  • personality changes
  • thought slowness
  • affective symptoms
  • executive skills e.g planning, decisions
33
Q

what are Lewy bodies

A

neuronal inclusions composed of proteins aggregated with ubiquitin + alpha-synuclein

34
Q

location of lewy bodies in lewy body dementia

A

substantia nigra

35
Q

medx avoided in Lewy Body dementia

A

neuroleptics

36
Q

3 features of Lewy Body dementia

A
  • progressive cognitive impairment
  • Parkinsonism
  • visual hallucinations
37
Q

scan that can be used to diagnose Lewy body dementia

38
Q

pathophysiology of fronto-temporal dementia

A

intracellular clumps of protein: Tau + TDP-43

39
Q

features of frontotemporal dementia and the causative area:

A

Atrophy of anterior temporal lobe = agnosia + dysphasia

Atrophy of frontal lobe = behavioural problems, emotional control, planning, motor function

40
Q

3 genes associated with Frontotemporal dementia

A

C90RF72 - chromosome 9 - linked to MND
MAPT - chromosome 17: gene for protein Tau
GRN - chromosome 17

41
Q

1st line management of AD

A

AchE-I inhibitors

  • rivastigmine
  • donepezil
  • Galantamine
42
Q

2nd line management of AD

A

Memantine

NDMA receptor antagonist

43
Q

what are BPSD’s

A

Behavioural and psycological symptoms of dementia

44
Q

investigations to do prior to starting either cholinesterase inhibitors or NDMA receptor antagonists

45
Q

cholinesterase inhibitors and contraindicated for:

A

those with

  • bradykinesia
  • LBBB
  • prolonged QTc interval
46
Q

importance of checking U + E before starting Memantine

A

can cause renal failure

47
Q

cholinesterase inhibitors used in caution in;

A
  • gastric ulcers

- seizures

48
Q

6 therapy managements for BPSDs

A

1) cognitive stimulation therapy
2) CBT
3) Reminiscence therapy
4) Aromatherapy
5) Sensory stimulation
6) Music therapy

49
Q

when to offer antipsychotics to patients with dementia

A
  • at risk to harming themselves

- experiencing agitation, hallucinations, delusions that are causing severe distress

50
Q

pathological feature associated with Lewy Body Dementia

A

Alpha Synuclien

51
Q

which cognitive function test is an extension of the MMSE

52
Q

5 cognitive domains of ACE-III

A
  1. attention/orientation
  2. memory
  3. language
  4. verbal fluency
  5. visuospatial skills
53
Q

list of BPSDs

A
  • hallucinations
  • delusions
  • anxiety
  • agitation + aggressive behaviour
  • apathy
  • depressioon
  • irritability
54
Q

Mild diagnosis of Dementia

  • MMSE
  • ADL
A

MMSE 20-24

Able to manage independant life

55
Q

Moderate diagnosis of Dementia

  • MMSE
  • ADL
A

MMSE 10-20

Need help with ADLs

56
Q

Severe diagnosis of Dementia

A

MMSE < 10

Completely dependant for ADLs

57
Q

4 options for 24 hour care

A
  • General residential home
  • EMI residential home
  • General nursing home
  • EMI nursing home

Psychiatry (9 decks)

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