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Erin Y3 - Neurology > Dementia > Flashcards

Dementia Flashcards

1
Q

Pathology of Alzheimer’s disease

A

Beta-amyloid plaques

Neurofibrillary tangles of tau protein

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2
Q

Pathology of frontotemporal dementia

A

Extreme atrophy of frontal and temporal lobes
Pick’s cells, Pick’s bodies
Neurodegenerative proteinopathy (Tau)

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3
Q

Pathology of Lewy Body dementia and Parkinson’s disease dementia

A

Lewy bodies inside the neurons (contain a-synuclein)

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4
Q

Pathology of vascular dementia

A

Cerebrovascular disease, reduced blood flow to the brain leading to damage

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5
Q

Pathology of prion disease

A

Neurodegenerative proteinopathy = change of prion protein within the brain (CJD is most common)

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6
Q

What genes can be associated with autosomal dominant Alzheimer’s disease?

A

Amyloid precursor protein mutations (chromosome 21)
Presenilin 1
Presenilin 2
APOE gene (e4 allel e predisposes to disease)

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7
Q

What condition is associated with Alzheimer’s disease?

A

Down’s syndrome

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8
Q

Presentation of Alzheimer’s disease?

A 
Memory loss (short-term)
Dysphasia
Apraxia (visuospatial difficulties)
Agnosia
Anosognosia (lack of insight)
Insidious impairment of higher intellectual function with alterations in mood and behaviour
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9
Q

What are the different presentations of frontotemporal dementia?

A

Frontal presentation: behavioural variant

Temporal presentation: primary progressive aphasia (progressive non-fluent aphasia, sematic dementia)

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10
Q

Presentation of the behavioural variant of frontotemporal dementia

A

Behavioural and personality changes

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11
Q

Presentation of the progressive non-fluent aphasia variant of frontotemporal dementia?

A

Difficulty pronouncing or speaking words

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12
Q

Presentation of the progressive sematic dementia variant of frontotemporal dementia?

A

Impaired understanding of words

Fluent speech lacking meaning

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13
Q

What condition can be associated with frontotemporal dementia?

A

MND

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14
Q

What age group is affected by frontotemporal dementia?

A

<65yrs

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15
Q

Presentation of Lewy Body dementia

A 
2 of:
Visual hallucinations
Fluctuating cognition (delirium-like)
REM sleep behaviour disorder
Parkinsonism (not more than 1yr prior to onset of dementia, TRAP)
Positive DAT scan
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16
Q

Presentation of Parkinson’s disease dementia

A

Same symptoms as Lewy body dementia but have has PD syndrome for >1yr before dementia presentation

17
Q

Presentation of vascular dementia

A

Step-wise progression
Similar to Alzheimer’s disease
Dysphasia, dyscalculia, frontal lobe symptoms and affective symptoms more common than in Alzheimer’s

18
Q

What is the presentation of mild cognitive impairment?

A

Noticeable cognitive impairment with little deterioration of function

19
Q

What is the presentation of subjective cognitive impairment?

A

Patient feels they are cognitively impaired but cognitive testing and day to day function are normal
Normal memory lapses are interpreted as sinister

20
Q

MRI/CT in Alzheimer’s disease

A

Atrophy of temporoparietal lobes or medial temporal lobe

21
Q

MRI/CT in frontotemporal dementia

A

Atrophy of frontotemporal lobes

22
Q

DAT scan in Lewy Body dementia and Parkinson’s disease dementia

A

Reduction of presynaptic dopamine

Comma shape becomes full stop

23
Q

MRI/CT in vascular dementia

A

Widespread small vessel disease

24
Q

Alzheimer’s disease treatment

A

Anticholinesterase inhibitor: rivastigmine, donepezil, galantamine
NMDA receptor blockers: memantine
Antipsychotics: for agitation

25
Q

Frontotemporal dementia treatment

A

Antidepressants (trazadone), antipsychotic can help behavioural features

26
Q

Frontotemporal dementia prognosis

A

Rapidly progressive

Life expectancy - 2-10yrs

27
Q

Lewy Body dementia treatment

A

Anticholinesterase inhibitor: rivastigmine, donepezil
NMDA receptor blockers: memantine
Levodopa
Antipsychotics make symptoms worse

28
Q

Vascular dementia treatment

A

Reduction of vascular risk factors +/- anticholinesterase inhibitors

29
Q

CSF in Alzheimer’s disease

A

↓amyloid:↑tau ratio

30
Q

CSF in frontotemporal dementia

A

↑tau / normal amyloid

31
Q

CSF in CJD

A

↑protein 14-3-3

32
Q

Cause of normal pressure hydrocephalus

A

Excess CSF accumulated in the brain’s ventricles

Idiopathic disease of the elderly

33
Q

Triad of symptoms in normal pressure hydrocephalus

A

Hakim’s triad:
Abnormal gait
Urinary incontinence
Dementia

34
Q

In normal pressure hydrocephalus what would be seen after a lumbar drain test?

A

Mental capacity and physiotherapy assessment should improve

Erin Y3 - Neurology (17 decks)

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