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CSI > Dementia > Flashcards

Dementia Flashcards

1
Q

What does Emily suffer from?

A

Hypertension

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2
Q

What medication does she take for hypertension?

A

Amlodipine

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3
Q

What is dementia?

A

Syndrome where there is deterioration in memory, thinking, behaviour and the ability to perform everyday activities

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4
Q

What are the early signs of dementia?

A

Forgetfulness
Losing track of time
Becoming lost in familiar places

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5
Q

What are the middle stages of dementia?

A 
Forgetting recent events and names
Becoming lost at home
Difficulty with communication
Needing help with personal care
Behaviour changes e.g. wandering and repeated questioning
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6
Q

What are signs of late stage dementia?

A 
Becoming unaware of time and place 
Difficulty recognising loved ones
Need for assisted self care
Difficulty walking
Behaviour changes that escalate includes aggression
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7
Q

What test did the doctor use to assess Emily’s memory?

A

Six item cognitive repair test

6-CIT

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8
Q

Give some examples of question used in the 6-CIT

A 
What year is it?
What month is it?
Give the patient an address to remember with 5 components 
About what time is
Count backwards from 20
Say the months of the year in reverse
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9
Q

Why was the new scoring system introduced?

A

Gives questions that are appropriate to everyone
E.g. takes into account cultural differences

Allows for a range of marking, accounts for no. of errors made
Not simply right or wrong

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10
Q

What was the outcome of Emily’s test?

A

Mild cognitive impairment

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11
Q

What’s the deal with mild cognitive impairment?

A

A condition in which someone has minor problems with cognition- their mental abilities such as memory or thinking

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12
Q

What’s dementia?

A

A syndrome usually chronic or progressive in which there is deterioration in cognitive function beyond what is normally expected

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13
Q

Which members of the MDT can help Emily?

A 
Dementia social worker
Dietician 
Carer
Voluntary service
Specialist nurses 
Physiotherapist
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14
Q

Why are specialist nurses important?

A

Administrating medication

Taking care of issues e.g incontinence

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15
Q

What can an occupational therapist do?

A

Adapt her environment to her condition
E.g. mat in bath
Chair lift
Specialist kitchen utensils

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16
Q

Why are members of voluntary services important?

A

Depression
Loneliness
Less reliant on family members

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17
Q

At what point would Mrs Wilkins lack capacity to make her own decisions?

A

When she is no longer able to carry out one of the following:

  • understand information
  • retain information
  • weigh up pros and cons
  • communicate their decision
18
Q

What is the basis on the Mental Capacity Act?

A

Everyone has capacity until proven otherwise

19
Q

What must be true for someone to lack capacity?

A

They have an underlying condition that is causing the lack of capacitance

20
Q

Why does making decisions about capacity involve multiple people?

A

It is subjective

Must be signed of by two different doctors independently

21
Q

What if decisions have to made very quickly?

A

Lack of capacitance stands for 24 hours until someone else is able to make an assessment

22
Q

Who makes final decisions regarding adults without capacitance?

A

The medical team

Family’s views should be taken as guidance

23
Q

Why do we assess capacitance on multiple occasions over time?

A

Things change over time
May regain capacity
Or deteriorate and no longer have capacity

24
Q

What are the 4 most common types of dementia?

A

Alzheimer’s
Vascular
Lewy Body
Fronto-temporal dementia

25
Q

What are the classic features of Alzheimer’s?

A 
Memory lapses
Confusion 
Gradual onset 
Better long term memory 
50% of dementia cases
26
Q

What are the classic features of Vascular dementia?

A 
Multiple tiny infarcts due to atherosclerosis 
Symptoms of stroke e.g. paralysis 
Traced to cardiovascular problems 
Step-wise onset 
25% of dementia cases
27
Q

What are the risk factors for vascular dementia?

A 
Hypertension 
High cholesterol 
Diabetes
Smoking 
Obesity
28
Q

What are the main features of Lewy body dementia?

A 
Caused by a build of proteins in the brainstem 
Parkinson-like symptoms 
Hallucinations
Sleep disorders 
Confusion 
Tremor
29
Q

What are the main features of Frontal Temporal dementia?

A

Affects communication and speech
Behavioural and personality changes
Become disinhibited
Very difficult for families

30
Q

How would you explain extracellular amyloid plaques to a patient?

A

Build up of proteins in your brain

Avoid terms such as growths of lumps that may be associated with cancer

31
Q

How would you explain intracellular neurofibrillary tangles?

A

Mis-folding of proteins that have malformed that reduces the function of that cell

32
Q

How would you explain synaptic deterioration and neuronal death?

A

The connections between your nerve cells aren’t functioning properly
And some of the cells are dying

33
Q

How would you describe gross cerebro-cortical atrophy?

A

Due to these processes the volume of certain areas of your brian has been reduced

34
Q

Where are the posterior cingulate cortex?

A

See diagram
Above corpus callosum
Posterior side

35
Q

Where is the thalamus?

A

Centre of brain

36
Q

Where is the hippocampus?

A

Below the thalamus

37
Q

What are the areas most affected by Alzheimer’s?

A

Posterior cingulate cortex
Hippocampus
Anterior Thalamus

38
Q

What is the function implicated by posterior cingulate cortex?

A

Orientation

6-CIT: Year/ Month/ Time

39
Q

What is the function implicated by hippocampus?

A

Short term memory

6-CIT: Repeat address

40
Q

What is the function implicated by the anterior thalamus?

A

Attention

6-CIT: Count back from 20
Say months in reverse

41
Q

From the paper what are the key findings?

A

Reduced posterior cingulate volume
Reduced entorhinal cortex volume
Decreased fractional anisotrophy in the parahippocampal cingulum

42
Q

What is the limbic system?

A

Supports memory, emotion and behaviour

Includes the cingulate gurus, hippocampus, anterior thalamus, entorhinal cortex and other structures

CSI (17 decks)

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