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Dementia Flashcards

1
Q

What are Lewy bodies

A

Eosinophilic, intrcytoplasmic neuronal inclusion bodies

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2
Q

Features of Lewy body dementia

A

fluctuating
Hallucinations (visual)
Parkinsonism
REM sleep disorder

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3
Q

What is the most common cause of dementia

A

Alzheimer’s disease

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4
Q

Risk factors for Alzheimer’s

A 
old age
trisomy 21
FH
APP 
ApoE4
head injuries
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5
Q

Neurodegenerative proteinopathy in Alzheimer’s disease

A

B-amyloid plaques extracellularly

Tau neurofibrillary tangles intracellularly

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6
Q

Clinical presentation of Alzheimer’s

A

Memory loss and forgetfulness
chronic / insidious onset
lack of insight
later: difficulty with language, behaviour, depression and orientation

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7
Q

Management of Alzheimer’s disease

A

Mild/mod - AChE inhibitor rivastigmine

2nd line NMDA antagonist memantine

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8
Q

What is another name for frontotemporal dementia

FTD

A

Pick’s disease

atrophy of frontal and temporal lobes

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9
Q

What is the onset of FTD

A

early onset dementia

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10
Q

Features of FTD

A

frontal disinhibition
apathy
loss of insight
changes in character and social deterioration
aphasia: semantic and progressive non-fluent

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11
Q

Histological findings in FTD

A

Pick’s cells - swollen neurons

Pick’s bodies - intracytoplasmic filamentous inclusions

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12
Q

What is vascular dementia

A

cumulative damage to the brain via hypoxia ie successive cerebral infarcts

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13
Q

What is Creutzfeldt Jakob disease CJD/Prion disease

A

neurodegenerative disease with abnormal prion protein

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14
Q

What is gold standard investigation of CJD and its finding

A

Biopsy - spongiform change on histopathology

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15
Q

list acute forms of dementia

A 
transient global amnesia 
transient epileptic amnesia 
viral encephalitis 
trauma 
stroke
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16
Q

what is transient global amnesia

A

acute anterograde amnesia preserved knowledge of self

lasts 4-6 hours

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17
Q

what is transient epileptic amnesia

A

episodic isolated memory loss associated with temporal lobe seizures with response to AEDs

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18
Q

Prion disease is an acute/subacute/chronic cognitive disorder

A

subacute

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19
Q

what is the most common human prion disease

A

Creutzfeldt-Jakob disease

20
Q

what is CJD

A

neurodegenerative proteinopathy

21
Q

how many abnormal prions are needed for a harmful effect

A

1

domino effect

22
Q

what are the 4 subtypes of CJD

A

sporadic
variant
iatrogenic
genetic

23
Q

of which protein is there neurodegenerative proteinopathy in Alzheimer’s disease

24
Q

which pathways are disrupted in Alzheimer’s

A

cholinergic

25
Q

which investigations can be carried out in Alzheimer’s

A

MRI - atrophy
SPECT - reduced metabolism
CSF - reduced amyloid and increased tau protein

26
Q

of which protein is there neurodegenerative proteinopathy in FTD

27
Q

which other neurological disease can FTD be a part of

28
Q

investigations and findings for FTD

A

MRI - frontotemporal lobe atrophy
SPECT - decreased metabolism
CSF - increased tau, normal amyloid

29
Q

what is vascular dementia

A

gradual cognitive disorder with presence of cerebrovascular disease

30
Q

there is stepwise/gradual decline in vascular dementia

31
Q

of which protein is the neurodegenerative proteinopathy in DLB

A

a-synuclein

32
Q

which pathways are disrupted in DLB

A

cholinergic and dopaminergic

33
Q

DLB can worsen with neuroleptics such as haloperidol, true or false

A

true

haloperidol should never be given in parkinsonism

34
Q

investigations in DLB

A

DaTSPECT scan
a-synuclein ligand imaging
a-synuclein CSF

35
Q

management of DLB

A

small dose levodopa
trial anticholinesterases
support

36
Q

core criteria of DLB

A

fluctuating cognition
recurrent well formed visual hallucination
presence of extrapyramidal features
also neuroleptic sensitivity

37
Q

what is the difference between DLB and PD dementia

A

in someone with PD:
dementia within 1 year of presentation = DLB
dementia after 1 year of presentation = PDD

38
Q

triad of features in huntington’s disease

A

emotional
cognitive
motor

39
Q

management of Huntington’s disease

A

mood stabilisers
treatment for chorea
nurse specialist

40
Q

who do you refer >65 yo with gradual onset dementia with no additional neurology to?

A

old age psychiatry

41
Q

who do you refer <65 yo with unusual features of dementia to

42
Q

what is the dementia screen for blood tests

A 
B12
folate
TFT
syphilis
HIV
Ca
genetics
43
Q

of which protein is there neurodegenerative proteinopathy in huntington’s disease

A

huntington protein

44
Q

CSF of Alzheimer’s:

there is high/low B amyloid and high/low Tau

A

low B amyloid

high Tau

45
Q

what kind of stroke are patient with Alzheimer’s disease at risk of and why

A

Haemorrhagic stroke

B-amyloid deposits (cerebral amyloid angiopathy)

Neurology (25 decks)

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