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Year 2 Neuro > Dementia > Flashcards

Dementia Flashcards

1
Q

What is Alzheimer’s?

A

Fatal, neurodegenerative disorder characterised by progressive cognitive, social and functional impairment

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2
Q

What are the common causes of dementia?

A

Alzheimer’s
Vascular dementia
Frontotemporal dementia
Dementia with Lewy Bodies

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3
Q

What are the potentially reversible causes of dementia?

A 
Depression
Alcohol related brain damage
Endocrine 
Vitamin B deficiencies 
Benign Tumors
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4
Q

Why is hard to diagnose dementia?

A

Follows a heterogenous course
In old age the disease presentation is of multiple co-morbidities
Lots of mixed/uncertain pictures

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5
Q

What is on the checklist when testing for dementia?

A 
Memory
Language
Numerical skills
Executive skills 
Visuospatial skills
Neglect phenomena
Visual perception
Rout finding and landmark identification
Personality and social conduct
Sexual behaviour
Eating
Mood
Motivation/Apathy
Anxiety
Delusions/Hallucinations
Activities of daily living
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6
Q

What is dementia?

A

Severe loss of memory and other cognitive abilities which leads to impaired daily function (regardless of the underlying cause)

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7
Q

What investigations might you carry out?

A

Neuropshychology
Bloods
MRI
PET

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8
Q

What Blood test might you carry out?

A 
FBS
Inflammatory markers
Thyroid function
Renal function
Glucose
B12 and folate
Clotting
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9
Q

What infections might you screen for?

A

Syphilis serology
HIV
Caeruloplasmin

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10
Q

What is a sMRI?

A

Structural MRI

Coronal T1

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11
Q

What do you see on an sMRI in Alzheimer’s?

A 
Narrow gyro
Widened sulk
Ventricles dilate 
Medial temporal volume loss
Hippocampus volume loss
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12
Q

How do you manage dementia?

A 
Acetylchloinsterase inhbitors
Watch and wait
Treat behavioural symotoms
Anti-depressants
Social Services
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13
Q

What must you do when diagnosing dementia?

A

Rule in and rule out other conditions

e.g. delirium or depression

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14
Q

How does Alzheimer’s present?

A

Subtle

Insidious amnestic or non-amnestic presentations

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15
Q

How does vascular dementia present?

A

Related to cerebrovascular disease with a classical step-wise deterioration +/- multiples infarcts

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16
Q

How does dementia with multiple Lewy bodies present?

A

Cognitive impairment before/within 1 year of parkinsonian symptoms, visual hallucinations and fluctuating cognition

17
Q

How does frontotemporal dementia present?

A

Behavioural variant
Semantic dementia
Progressive non-fluent aphasia

18
Q

What is really important when taking a dementia history?

A

What family/carers say

19
Q

What is the MMSE?

A

Mini mental state examination

20
Q

What is ACE?

A

Addenbrooks cognitive assessment

21
Q

What is episodic memory?

A

Memory for a particular episodes in life

Dependent on the medial temporal lobes including the hippocampus

22
Q

How can diagnosis be made in vivo?

A

Amyloid PET

CSF taken by lumbar puncture (tau will be higher in Alzheimer’s)

23
Q

How does dementia with Lewy bodies look different on an MRI?

A

Preserved hippocampal volume

24
Q

What is the purpose of the mock up of the MoCa?

A

So that those with dementia are able somewhat experience what it is like to take it

‘the impossible MoCA

25
Q

What section of the Addenbrooke’s cognitive examination would someone with Alzheimer’s struggle with?

A

Name and address
Acute memory
Inability to lay down new memories

26
Q

What must be taken into account when conducting the ACE?

A

The context of the individual
Socio-economic situation
Educational background
Political awareness and social interaction

27
Q

What metrics in the ACE would people with visuospatial issues struggle with?

A

Drawing
Identifying partial letters
Look at diagrams and count the spots without pointing

28
Q

What is the underlying issue with dementia care?

A

Contact
Primary care consultations are online
Would be difficult to administer cognitive tests online
No non-verbal queues to guide clinical observation
People become even more isolated

Year 2 Neuro (15 decks)

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