Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Y2 CONTROL & MOVEMENT > Dementia > Flashcards

Dementia Flashcards

1
Q

What is the definition of dementia?

A

a progressive and largely irreversible syndrome that is characterised by a widespread impairment of mental function

sufficiently severe to impair social and occupational functioning

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What care needs are implicated in dementia?

A

dementia is associated with complex needs and high levels of dependency and morbidity

care needs often challenge the skills and capacity of carers and available services

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the 6 types of neurodegenerative dementia?

Which is the most common and least common?

A

most common - Alzheimer’s disease

  • vascular dementia
  • mixed dementia
  • lewy body disease
  • fronto-temporal dementia

least common - Parkinson’s dementia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

In which 3 ways can dementia be classified?

A
  • site in the brain
  • age
  • pathology
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What kind of symptoms are produced from disease of the frontal lobes?

A

it produces abnormalities in several behavioural domains

abnormality leads to impaired:

  • judgement
  • abstract reasoning
  • strategic planning
  • emotional restraint
  • control of appetite and continence
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What does disease of the medial temporal lobe, hippocampus, amygdala and limbic system lead to?

A

disorders of memory and hallucinations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the symptoms of disorders of the temporal neocortex?

A

receptive dysphasia and automatisms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is receptive dysphasia and expressive dysphasia?

A

receptive dysphasia:

  • difficulty in comprehension and understanding
  • can speak words fluently, but they do not make sense

expressive dysphasia:

  • difficulty putting words together to make meaning
  • comprehension is intact
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What symptoms arise due to disorders of the occipital lobe?

A

failure of the visual and sensory systems

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What symptoms arise from disease of the parietal lobe?

Why do they occur?

A

impairment of visuospatial skills and integration of sensory inputs

this leads to sensory agnosias and apraxias

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is meant by an automatism?

A

an action that is performed unconsciously or involuntarily

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the 4 categories of classification of dementia based on site?

A
  1. anterior
  2. posterior
  3. subcortical
  4. cortical
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the symptoms of a condition affecting the anterior region?

What are examples of conditions which arise?

A

frontal premotor cortex

  • behavioural changes / loss of inhibition
  • antisocial behaviour
  • facile and irresponsible

seen in normal pressure hydrocephalus, Huntington’s chorea and metabolic disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What symptoms arise from a problem in the posterior region?

What condition results from this?

A

parietal and temporal lobes

  • disturbance of cognitive function (memory & language) without marked changes in behaviour

seen in Alzheimer’s disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the symptoms of a problem in the subcortial site?

What conditions results from this?

A
  • apathetic
  • forgetful and slow with poor ability to use knowledge
  • associated with other neurological signs and movement disorders

seen in Parkinson’s disease and AIDS dementia complex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the symptoms associated with a problem in the cortical region?

A

higher cortical abnormalities including:

  • dysphasia
  • agnosia
  • apraxia

this is seen in Alzheimer’s disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is meant by agnosia and apraxia?

A

agnosia:

  • inability to interpret sensations and recognise things

apraxia:

  • individual has difficulty with the motor planning to perform tasks or movements when asked
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is meant by young onset dementia?

A

a young onset age is < 65 years

it is not always memory that is affected

this may be genetic or metabolic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What types of dementia are present in people aged above and below 65?

A

age above 65:

  • alzheimer’s
  • vascular
  • lewy body

age less than 65:

  • alzheimer’s
  • vascular
  • fronto-temporal
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are the three categories in the molecular-genetic classification of neurodegenerative diseases?

A

tauopathies:

  • characterised by neuronal and/or glial inclusions composed of the microtubule-binding protein, tau

synucleinopathies:

  • characterised by abnormal accumulation of aggregates of alpha-synuclein protein in neurones, nerve fibres or glial cells

ubiquinopathies:

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are examples of tauopathies?

A
  • FTD and FTDP-17
  • progressive supranuclear palsy (PSP)
  • corticobasal degeneration
  • Alzheimer’s disease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What are examples of synucleinopathies?

A
  • parkinson’s disease
  • dementia with lewy bodies
  • multiple system atrophy (MSA)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What are examples of ubiquinopathies?

A
  • motor neurone disease (MND) and MND / dementia
  • semantic dementia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q
A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What steps are required in the diagnosis of dementia?

A
  • history - GP, memory clinic, neurologist, psychiatrist
  • examination
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What type of information is crucial when diagnosing dementia?

A

collateral information (from other people)

time-scale is also important to identify whether it is a rapidly progressive dementia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What are the 2 stages involved in cognitive assessment for dementia?

A

screening tests:

  • MMSE
  • ACE-III
  • MoCA

neuropsychological assessment:

  • objective vs subjective deficit
  • how many cognitive domains are affected
  • which cognitive domains are affected
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What additional tests may be performed when diagnosing dementia?

A
  • blood tests
  • structural brain imaging (CT, MRI)
  • functional brain imaging (PET, DaT)
  • lumbar puncture (biomarkers)
  • genetic blood tests
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What is the 2 main features that are affected in Alzheimer’s disease?

A

episodic memory:

  • patients are forgetful and repetitively ask the same questions

orientation:

  • patients get lost in familiar places
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What is meant by episodic memory?

A

the memory of every day events such as:

  • times
  • location geography
  • associated emotions
  • who, what, where, when, why knowledge

that can be explicitly stated or conjured

it is a collection of past personal experiences that occurred at a particular time and place

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q
A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

How does a patient with Alzheimer’s present initially?

How does this change with disease progression?

A
  • in early stages the personality is unchanged and they maintain a good social facade
  • the patient lacks insight and head-turning sign is present
  • there are eventually more widespread deficits
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What is meant by head-turning sign in Alzheimer’s disease?

A

patients who turn their head toward their caregiver for assistance or cues to help them answer questions are more likely to have Alzheimer’s dementia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What are useful questions to ask patients with Alzheimer’s disease?

A
  • how did you get here?
  • what did you do this morning?
  • what has been happening in the news lately?
35
Q

What investigations are performed in Alzheimer’s disease and what are the expected results?

A

cognitive assessment

examination:

  • may have myoclonus or UMN signs

CT/MRI brain scan:

  • medial temporal lobe atrophy

FDG-PET scan:

  • posterior hypometabolism

CSF biomarkers:

  • raised tau
  • low a-beta
36
Q

What is meant by myoclonus?

A

spasmodic jerky contraction of groups of muscles

37
Q

What is posterior cortical atrophy?

What causes the symptoms?

A

a form of dementia that is usually considered an atypical variant of Alzheimer’s disease

it causes atrophy of the posterior part of the cerebral cortex

this results in decline in visuo-spatial processing skills with relatively intact memory

38
Q

What are some of the symptoms and signs of posterior cortical atrophy?

A
  • vague hemianopia - tend to get lost whilst reading
  • reverse size phenomenon - small print is easier to read than large
  • cannot judge distances so problems with driving / parking
  • difficultly identifying a static object (can still catch a ball)
  • difficulty reading fragmented letters
  • visual crowding (easier to read letters when they are spaced out)
  • light sensitivity and distortion - difficulty with glass / mirror surfaces and prolonged colour after-images
39
Q

What is hemianopia?

A

blindness over half the field of vision

40
Q

What is fronto-temporal dementia?

What are the typical symptoms and areas affected?

A

a group of non-Alzheimer’s neurodegenerative disorders

memory is intact but language, behaviour and personality are affected

41
Q

When is the typical onset of fronto-temporal dementia?

A

onset is in middle life (50-65 years)

up to 50% of cases are familial (consider genetic testing)

there are overlap syndromes (motor neurone disease, parkinsonism, etc.)

42
Q

What are the 4 subtypes of frontal-temporal dementia?

A
  1. behavioural
  2. semantic
  3. progressive non-fluent aphasia
  4. logopenic aphasia
43
Q

What are the features of behavioural FTLD?

A
  • disinhibited, socially inappropriate, apathy, loss of insight
  • sweet tooth
  • repetitive behaviours
  • executive dysfunction
44
Q

What are the features of semantic FTLD?

A
  • fluent but empty speech
  • anomia - inability to recall names of everyday objects
  • impaired word comprehension
  • surface dyslexia
45
Q

What are the features of progressive non-fluent aphasia?

A
  • effortful non-fluent speech
  • phonemic errors
  • articulation
  • orofacial apraxia
  • insight is retained
46
Q

What is orofacial apraxia?

A

a loss of voluntary control of facial, lingual, pharyngeal and masticatory muscles in the presence of preserved reflexive and automatic function of the same muscle

47
Q

What are the features of logopenic aphasia?

A
  • hesitant by grammatically correct speech
  • impaired phrase repetition
48
Q
A
49
Q

what are the 3 main features of progressive non-fluent aphasia?

A
  • effortful non-fluent speech
  • phonemic errors
  • orofacial apraxia (tested by asking the patient to cough or yawn)
50
Q

What are the 3 main features of semantic dementia?

A
  • fluent but empty speech
  • impaired word comprehension
  • surface dyslexia

patient may have trouble finding names for people and objects and make spelling mistakes

51
Q

what is meant by surface dyslexia?

A

a disorder characterised by the inability to read words with “irregular” or exceptional print-to-sound correspondences

e.g. “pint” or “soot”

52
Q

How would someone with behavioural variant dementia present?

A
  • disinhibited
  • impulsive
  • apathetic
  • compulsive overeating
  • executive dysfunction
53
Q

What are the stages involved in investigating dementia?

A
  • history
  • examination
  • blood tests
  • imaging
54
Q

What are “treatable” conditions that result from dementia?

A
  • depression
  • iatrogenic (anticholinergics, sedatives, narcotics, H2 blockers, multiple meds)
  • hypothyroidism
  • B12 deficiency
  • neurosyphylis
  • HIV
  • normal pressure hydrocephalus
  • subdural haematoma
  • encephalitis
55
Q

What is normal pressure hydrocephalus a triad of?

A

1. dementia

2. gait disturbance

3. urinary incontinence

occurring in conjunction with hydrocephalus and normal CSF pressure

56
Q

What are the 2 different types of normal pressure hydrocephalus?

A
  1. NPH with a preceding cause
    e. g. SAH, meningitis, trauma, radiation induced
  2. NPH with no known preceding cause (idiopathic)
57
Q

What is shown in this image?

A

normal pressure hydrocephalus

there is an accumulation of CSF that causes the ventricles in the brain to become enlarged

sometimes there is little or no increase in intracranial pressure

58
Q

What type of condition looks like this?

A

transmissible spongiform encephalopathies

under a microscope, the affected brain tissue looks like a sponge

59
Q

What is the median age of death in classic (sporadic) and variant CJD?

A

classic CJD - 68 years

variant CJD - 28 years

60
Q

What is the median duration of illness in classic and variant CJD?

A

classic CJD - 4-5 months

variant CJD - 13-14 months

61
Q

What are the clinical signs and symptoms in classic and variant CJD?

A

classic CJD:

  • dementia
  • early neurologic signs

variant CJD:

  • prominent psychiatric / behavioural symptoms
  • painful dyesthesiasis
  • delayed neurologic signs
62
Q

What types of test signs are present in sporadic and variant CJD?

A

classic CJD:

  • periodic sharp waves on electroencephalogram often present

variant CJD:

  • “pulvinar sign” on MRI present in >75% of cases
  • presence of florid plaques on neuropathology present in large numbers
63
Q

What signs are present in tissue in sporadic and variant CJD?

A

classic CJD:

  • immunohistochemical analysis of brain tissue shows variable accumulation

variant CJD:

  • immunohistochemical analysis of brain tissue shows marked accumulation of protease-resistant prion protein
  • presence of agent in lymphoid tissue is readily detected
64
Q

What would be seen in an EEG in CJD?

A

triphasic waves on repeat testing

65
Q

What would be seen on an MRI for sporadic CJD?

A

non-specific changes in the basal ganglia

66
Q

What would be seen on an MRI for variant CJD?

A

a characteristic abnormality seen in the posterior thalamic region - pulvinar sign

this is highly sensitive and specific for vCJD

67
Q
A
68
Q

What is corticobasal degeneration?

How does it usually present?

A

rare progressive neurological disorder characterised by cell loss and deterioration of a specific area of the brain

affected individuals often initially experience motor abnormalities in one limb which eventually spreads to affect all the arms and legs

69
Q

What are the signs and symptoms of corticobasal degeneration?

A
  • apraxia - difficulty with motor planning to perform tasks when asked
  • alien limb - limbs act on their own without conscious control
  • balance, co-ordination, parkinsonism / PSP
  • speech and cognitive
70
Q

What would an MRI for corticobasal degeneration show?

What is the underlying pathology?

A
  • asymmetrical atrophy
  • usually parietal and basal ganglia

the pathology is tauopathy

71
Q

What is encephalitis?

What are the 3 main categories?

A

inflammation of the brain caused by an infection or through the immune system attacking the brain in error

  1. viral
  2. autoimmune
  3. paraneoplastic
72
Q

What are the viral causes of encephalitis?

A

herpes simplex virus

seen on MRI and in CSF

73
Q

What are the autoimmune causes of encephalitis?

A

antibodies are present in the blood and CSF

this is usually the voltage gated potassium channel antibody (VGKC Ab LE)

74
Q

What is meant by paraneoplastic causes of encephalitis?

A

neuronal antibodies are present in the blood, body examination and imaging

75
Q

What are the symptoms and signs of VGKC Ab limbic encephalitis?

A
  • subacute memory loss
  • psychiatric / behavioural disturbance
  • seizures - usually partial
  • hyponatraemia
76
Q

What is present in most cases of VGKC Ab limbic encephaltis?

what tumours may be present?

A

most cases have serum and CSF antibodies to the LGI1 subunit of the K channel

others have CASPR2

thymoma/SCLC and other tumours may be present, but they are not associated

77
Q
A
78
Q

What is the difference in functions of the anterior and posterior aspects of the brain?

A

the frontal aspect of the brain is involved in executive functions such as motor, planning and strategic thinking

the posterior aspect is involved in perception / integration of sensory stimuli and encoding knowledge

79
Q

What is the role of the limbic system?

A

arousal, emotion, motivation, attention and memory

80
Q

What are the 8 different diseases of dementia?

A
  • alzheimer’s disease
  • vascular dementia
  • frontotemporal lobar degeneration
  • dementia with parkinsonism
  • idiopathic parkinson disease
  • dementia with lewy body
  • corticobasal degeneration
  • progressive supranuclear palsy
  • normal pressure hydrocephalus
  • creutzfeldt-jakob disease
81
Q

What are the 5 different proteins which may be involved in dementia?

A
  • B-amyloid
  • Tau
  • a-synuclein
  • TDP-43
  • ubiquitin
82
Q

What are the 2 things involved in the general pathology of dementia?

A
  • neurone loss from the hippocampus and cerebral cortex
  • accumulation of abnormal proteins
83
Q

Where do the abnormal proteins seen in dementia accumulate?

A

B-amyloid is in plaques and amyloid angiopathy

Tau in neurofibrillary tangles

a-synuclein in lewy bodies

ubiquitin in Pick’s bodies

84
Q
A

Y2 CONTROL & MOVEMENT (69 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions