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Psychiatry > Dementia > Flashcards

Dementia Flashcards

1
Q

What is dementia?

A

Syndrome of generalised decline of memory, intellect and personality without impairment of consciousness, leading to functional impairment

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2
Q

What are the main types of dementia?

A

Alzheimer’s disease
Vascular
Fronto-temporal dementia
Dementia with Lewy bodies

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3
Q

What are irreversible causes of dementia?

A 
Neurodegenerative
- Alzheimer's
Fronto-temporal 
- Dementia with Lewy bodies
- Huntington's disease

Infections
Toxins
Vascular dementia
Traumatic head injury

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4
Q

What are the reversible causes for dementia?

A

Neurological

  • normal pressure hydrocephalus
  • intracranial tumours

Vitamin deficiencies
Cushing’s syndrome
Hypothyroidism

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5
Q

What are the ICD-10 criteria for dementia?

A

Evidence of

  • decline in memory
  • decline in other cognitive abilities characterised by deterioration in judgement and thinking

Preserved awress of environment long enough to show decline

A decline in emotional control or motivation or change in social behaviour shown by

  • emotional lability
  • irritability
  • apathy
  • coarsening of social behaviour

Present for at least 6 months

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6
Q

What is the pathophysiology of Alzheimer’s?

A

Degeneration of cholinergic neurons in nucleus basalis - deficiency of acetylcholine

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7
Q

What are the microscopic changes seen in Alzheimer’s?

A

Intracellular neurofibrillary tangles

Extracellular B-amyloid plaques

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8
Q

What are the macroscopic changes seen in Alzheimer’s?

A

Cortical atrophy
Widened sulci
Enlarged ventricles

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9
Q

What are risk factors for Alzheimer’s?

A 
Increasing age
Family history 
Genetics
Down's syndrome 
Low IQ
Cerebrovascular disease
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10
Q

Which genes are associated with Alzheimer’s?

A

Early onset

  • Presenilin 1 (chromosome 14)
  • Presenilin 2 (chromosome 2)
  • Amyloid precursor protein (chromosome 21)

Late onset
- ApoE-4 (chromosome 19)

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11
Q

What are the features of early stages of Alzheimer’s?

A

Memory lapses
Difficulty finding words
Forgetting names

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12
Q

What are features of disease progression in Alzheimer’s?

A

Apraxia
Confusion
Language problems
Difficulty in executive thinking

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13
Q

What is exectutive thinking?

A 
Problem solving 
Reasoning 
Decision making 
Visuospatial abilities
Language skills
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14
Q

What are features of later stages of Alzheimer’s?

A 
Disorientation to time/place
Wandering 
Apathy 
Incontinence
Eating problems 
Depression
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15
Q

What are the ICD-10 criteria for Alzheimer’s?

A

General criteria for dementia met

No evidence for any other cause

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16
Q

What are the ICD-10 criteria for early onset Alzheimer’s?

A

General criteria met + <65

At least one of

  • rapid onset and progression
  • aphasia
  • agraphia
  • alexia
  • acalculia
  • apraxia
17
Q

What are the ICD-10 criteria for late onset Alzheimer’s?

A

General criteria met + >65

At least one of

  • slow onset and progression
  • memory impairment over intellectual impairment
18
Q

What is aphasia?

A

Impairment of language

19
Q

What is agraphia?

A

Decreased ability to communicate through writing

20
Q

What is alexia?

A

Reduced ability to read

21
Q

What is acalculia?

A

Decreased ability to do maths

22
Q

What is apraxia?

A

Inability to carry out previously learned purposeful movements

23
Q

What is the pathophysiology of vascular dementia?

A

Cerebrovascular disease

24
Q

What is the progression of vascular dementia?

A

Stepwise

25
Q

What are the features of vascular dementia?

A 
Memory loss
Emotional changes
Personality changes 
Confusion 
Neurological signs
26
Q

What is the pathophysiology of Lewy body dementia?

A

Abonormal deposition of Lewy bodies in neurons

27
Q

What are the features of Lewy body dementia?

A 
Day to day fluctuations in cognition 
Visual hallucinations
Motor Parkinson's signs
- tremor
- rigidity 
- bradykinesia
28
Q

How is Lewy body dementia differentiated from Parkinson’s with dementia?

A

Lewy body dementia = dementia + Parkinsonism within 12 months of each other

29
Q

What is the pathophysiology of fronto-temporal dementia?

A

Atrophy of frontal and temporal lobes

30
Q

What are the features of fronto-temporal dementia?

A 
Disinhbition 
Apathy 
Loosening of social behaviour 
Repetitive behaviour 
Language problems
31
Q

How is dementia managed?

A

Supportive treatment
Advance planning
Social support

Pharmacology

  • acetylcholinesterase inhibitor
  • treat low mood

Psychiatry (22 decks)

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