Brainscape's Knowledge GenomeTM

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


See full index

Psychiatry > Dementia > Flashcards

Dementia Flashcards

1
Q

define dementia

A

an acquired progressive impairment of cognition without clouding of consciousness that has been present for at least 6 months

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

state the 6 domains that cognition is assessed in

A 
language 
movement 
visuospatial 
memory 
executive functioning 
behaviour
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

for a dementia to be present there must be how many cognitive domains affected

A

2

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

outline some general features of cognitive decline

A 
memory loss 
slow, muddled thinking 
disorientated in space and time 
restlessness 
reduced attention and concentration 
loss of insight 
repetitive actions 
odd and disorganised behaviour
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

outline some primary causes of dementia

A

Alzheimers
Lewy body
Pick’s disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

outline some secondary causes of dementia

A

vascular dementia due to CVS disease
CJD or infection
huntingtons and Parkinson’s causing secondary dementia
alcohol abuse or head injury

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

what is the most common cause of dementia

A

Alzheimers disease

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

what gene has a defect in Alzheimers

A

ApoE gene

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what are the macroscopic features of Alzheimers

A

cortical atrophy with thinning of gyri and sulci - occipital lobe spared
compensatory ventricular enlargement

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

what protein is there depositions of in Alzheimers disease

A

B-amyloid proteins

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

what are neurofibrillary tangles in Alzheimers and what protein are they formed from

A

filament bundles between the neurones - formed from tau protein

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

what is the effect on ACh neurotransmission in Alzheimers

A

reduced ACh in the nucleus Basilis of meynet

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what is the initial symptom seen in Alzheimers

A

progressive memory loss, initially short term then followed by long term memory

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

describe the speech disorder in Alzheimers

A

dysphasia, trouble getting words out and understanding speech

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

describe some of the behavioural changes in Alzheimers

A

restlessness, agitation, aggressive outburst

associated with low mood and poor sleep

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

what are the findings on MRI in Alzheimers

A

usually normal, may have medial temporal lobe atrophy

usually imaging not required in suspected Alzheimers

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

who is at risk of developing vascular dementia

A

more common in men

those with increased CVS risks such as hypertension, hyperlipidaemia etc

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what causes vascular dementia

A

develops as a result of small vessel infarcts within the white matter, grey nuclei and thalamus

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

what is the initial presentation in vascular dementia

A

functional deficits such as gait disturbance and urinary incontinence before memory problems

20
Q

how does vascular dementia progress

A

in a stepwise progression, disease worsens then remains the same before getting worse even more

21
Q

what are the emotional changes seen in vascular dementia

A

mood disturbances and disorders are very common

22
Q

who is most likely to develop Lewy body dementia

A

men more commonly affected

>50 years

23
Q

what causes Lewy body dementia

A

degeneration of substantiated Nigra and cortex

microscopically shows levy body deposition in substantial Nigra and cortex

24
Q

what domains are affected first in Lewy body dementia

A

defects in executive functioning and visuospatial skills rather than memory loss

25
Q

how does Lewy body dementia present

A

visual hallucinations
Parkinsonism
fluctuating cognitive ability
REM sleep disorders

26
Q

how can you differentiate between Lewy body dementia and Parkinsons with secondary dementia

A

Lewy body the cognitive decline is seen before or at the same time as the onset of Parkinsonism
Parkinsons the cognitive decline will be at least a year after the onset of Parkinsonism

27
Q

what is the pathophysiology of frontotemporal dementia

A

atrophy of the frontotemporal lobes

deposition of abnormal tau proteins

28
Q

what is a specific type of frontotemporal dementia

A

Pick’s disease

29
Q

what is the initial presentation of frontotemporal dementia

A

general change in premorbid personality

30
Q

describe the behavioural changes seen in frontotemporal dementia

A 
altered emotional responsiveness
apathy
disinhibition 
impulsivity 
reduced interpersonal skills 
diet change
31
Q

describe the changes with speech seen in frontotemporal dementia

A

either wernickes or brocas aphasia

32
Q

list some secondary causes of dementia

A

Huntingtons disease
normal pressure hydrocephalus
mad cow disease - CJD

33
Q

what causes CJD

A

Prion disease

34
Q

describe the presentation of CJD

A

presents in <50s
memory lapses and mood disturbances, evolves into unsteadiness and clumsiness in a few weeks
stiffness, jerking, incontinence and aphasia

35
Q

what is the prognosis of CJD

A

not great, usually dead 6 months after presentation

36
Q

what aids the diagnosis of a cognitive impairment

A

cognitive tests

37
Q

what is the first cognitive test usually done to assess a patient with suspected dementia

A

mini mental state examination

38
Q

an MMSE score of less than what is suggestive of cognitive impairment

A

less than 24

MMSE is out of 30

39
Q

what are the more in-depth assessments for cognition

A

MOCA and ACE III

40
Q

outline the non-pharmacological treatment of dementia

A

MDT input, possibly from Alzheimer’s Scotland too
care services
incontinence pads
house assessment by OT, dose boxes and dementia clock
community alarm

41
Q

what is the first line drug used in dementia

A

cholinesterase inhibitors

42
Q

what are examples of cholinesterase inhibitors

A

donepezil
rivastigmine
galantamine

43
Q

rivastigmine is particularly useful in which dementia

A

Lewy body dementia

44
Q

how do cholinesterase inhibitors work

A

increase cholinergic transmission in the brain delaying cognitive decline

45
Q

what are the side effects of cholinesterase inhibitors

A

GI upset
headache
muscle cramping
contraindicated in asthma, COPD and active peptic ulcer disease

46
Q

which drug is indicated in severe Alzheimers for when cholinesterase inhibitors have failed to work

A

NMDA antagonists such as memantine

47
Q

are anti-psychotics useful for agitation in dementia

A

should be avoided due to s/e, particularly in Lewy body dementia

Psychiatry (14 decks)

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