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Neurology > Dementia > Flashcards

Dementia Flashcards

1
Q

what is the leading cause of dementia?

A

alzheimer’s disease

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2
Q

what is the main risk factor for AD?

A

age

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3
Q

the prevalence of AD increase after the age of ?

A

60 years

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4
Q

mutations in what genes cause AD?

A

APP or PSEN or apolipoprotein E4 allele variants

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5
Q

ApoE2 ————- risk

A

decreases

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6
Q

ApoE4———— risk

A

increases

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7
Q

patients with which genetic condition have an increased risk of developing AD?

A

Down syndrome

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8
Q

injuries to which part of the body can increase risk of developing AD?

A

head

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9
Q

what is the histological presentation of dementia?

A

excess accumulation of extracellular B-amyloid plaques and intracellular neurofibrillary tangles (aggregates of Tau protein)

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10
Q

there is widespread —————– atrophy

A

cortical

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11
Q

there is —————- of gyri and —————– of sulci

A

narrowin and widening

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12
Q

what are the areas of the brain which can be first affect in AD? (3)

A

nucleus basalis of meynert

entrohinal cortex and hippocampus

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13
Q

there is ——— and ———– onset of worsening memory in AD

A

insidious and progresssive

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14
Q

early symptoms of AD reflect impairment of which type of memory?

A

episodic memory

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15
Q

AD is not associated with?

A

behavioural or personality changes

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16
Q

with AD there are often early subtle impairments of? (4)

A

planning, decision making, working out complex sequences and learning new tasks

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17
Q

as the AD progresses there are difficulties with?

A

languae, bheavioural problems (such as aggression), depression and disorientation becomes more pronounced

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18
Q

what tools are used for diagnosis?

A

MMSE, MRI and SPECT scan

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19
Q

what are the CSF biomarkers in AD?

A

increase in phosphorylated tau protein and decrease in B-amyloid

20
Q

what do you use to treat patients with AD (mild to moderate)

A

acetylcholinesterase inhibitors (donepezil,galantamine or rivastigimine)

21
Q

what is used for patients who are intolerant of or have a contraindication to EChE inhibitors or have severe AD?

A

memantine

22
Q

what type of drug is menantine?

A

voltage dependent non-competitive N-methyl-D-aspartate (NMDA) receptor antagonist

23
Q

what are thee complications of AD?

A

haemorrhagic stroke due to B-amyloid deposits in cerebral blood vessels that can weaken them

24
Q

haemorrhagic stroke due to B-amyloid deposits in cerebral blood vessels that can weaken them

A

cerebral amyloid angiopathy

25
Q

what is frontotemporal dementia?

A

group of neurodegenerative disorders characterised by relatively focal frontal and temporal cerebral atrophy

26
Q

what are teh three broad syndromic variants of frontotemporal dementia?

A

behavioural variant
semantic dementia
progressive non-fluent aphasia

27
Q

what is the most common type of fTD?

A

behaviouraal variant

28
Q

what are the symptoms of FTD?

A

loss of inhibition , apathy, repetitive behaviours and diffulty planning

29
Q

what is characteristic of FTd behvaaioural variant/

A

memory is preserved in early disease and behavioural symptoms are more pronounced

30
Q

what are the two forms of primary progressive aphasia?

A

semantic dementia

and progressive non-fluent aphasia

31
Q

what is semanitc dementia?

A

impaired word comprehension and object naming

loss of recognition of familiar faces or objects

32
Q

impaired word comprehension and object naming

loss of recognition of familiar faces or objects

A

semantic dementia

33
Q

what is progressive non-fluent aphasia?

A

slow/hesitant speech, word finding deficits and agrammatism. may be associated orofacial apraxia

34
Q

slow/hesitant speech, word finding deficits and agrammatism. may be associated orofacial apraxia

A

progressive non-fluent aphasia

35
Q

how can orofacial apraxia be tested?

A

coughing or swallowing

36
Q

what investigation can be used to diagnose FTD?

A

MRI and lumbar puncture

37
Q

what is the second most common form of dementia?

A

vascular dementia

38
Q

what caauses vascular dementia?

A

vascular changes secondary to cerebrovascular disease

39
Q

what are the symptoms of vascular dementia?

A

executive and attentional impairments, behavioural changes (disinhibition), cognitive slowing, focal neurological problems and difficulty walking/falls

40
Q

what is the most appropriate imaging modality used to diagnose vascular dementia?

A

MRI

41
Q

what does MRI show in vaascular dementia?

A

the presence and location of infarcts and commonly shows white matter changes and patchy reduced attenuation in the cortex

42
Q

what is creugzfeldt-Jakob disease?

A

it is a transmissible prion neurodegenrative disease

43
Q

what does the prion cause in CJD?

A

cell death (spongiform changes in the cortex) and astrocytosis

44
Q

what doees CJD present with?

A

rapidly progressing dementia, ataxia and myoclonic jerks

45
Q

what is the best initial test for CJD/

A

EEG

46
Q

what is the charateristic feature of EEG in CJD/

A

pseudoperiodic sharp wave activity

47
Q

what does CSF analysis show in CJD?

A

elevated 14-3-3 protein

Neurology (10 decks)

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