Dementia

Question 1

Referrals

Answer 1

1. Memory clinic / service
   based in psychiatric or geri services
   urgent it challenging behavioural problems

2. neurological referral
focal neurological signs
<65 y/o
genetic cause suspected
urgent if rapid change/seizure

Question 2

important to note from history

Answer 2

GPCOG
educational level / occupation
functional and social ability
alcohol and drug hx

exam- physical exam and neuro

bloods: FBC, thyroid, calcium hba1c, renal, b12, folate

meds: anticholinergics
she: depression

Question 3

causes of dementia

Answer 3

alzheimers
vascular
lewy pody
frontotemporal
normal pressure hydrocephalus
alcohol related
HIV related
creutzfeld -jakob
huntington
MS
posterior cortical atrophy
progressive supra nuclear palsy

Question 4

Alzheimers dementia

Answer 4

mainly memory problem
can affect executive problems
can have poor insight
apraxia and sleep disturbances are late signs
low mood and apathy not unusual

acetylcholinesterase inhibitors- donepazil, galantine, rivastigmine
NMDA receptor antagonist mematine

Question 5

vascular dementia

Answer 5

executive function and processing is effected

imaging changes

Question 6

Lewy body

Answer 6

sudden marked / fluctuation
REM disorder
visuospatial disorders
dysautonomia
neuroleptic sensitivity

Question 7

BPSD (behavioural and psychological symptoms in dementia)

Answer 7

apathy
aggression
agitation
mania
depression
psychosis