Dementia and Delirium

Question 1

Dementia definition

Answer 1

Affects > 1 cognitive function
Acquired
Progressive

Question 2

Types of dementia

Answer 2

Alzheimer's disease
Vascular dementia
Mixed AD and VD
Lewy Body dementia
Frontotemporal dementia

(Type only diagnosed post mortem)

Question 3

Alzheimer’s disease; Epi? Pathophysiology?

Answer 3

Most common dementia - 50% of cases
Cholinergic deficit
Beta amyloid and Tau

Question 4

RFs for Alzheimer’s

Answer 4

Age
F
Head injury
Downs syndrome
FH
Smoking

Question 5

Protective factors for dementia

Answer 5

Cognitive activity

Question 6

Diagnosing dementia

Answer 6

Hx - probable diagnoses given
Ix - rule out other causes
Cognitive tests

Question 7

Features of Lewy body dementia

Answer 7

Fluctuating cognition
Visual hallucinations
Motor features of parkinsonism

Question 8

Frontotemporal dementia epidemiology

Answer 8

Females more common

45-60 yrs

Question 9

Neuropathology of frontotemporal dementia

Answer 9

Pick cells
Pick bodies
Knife blade atrophy

Question 10

Features of frontotemporal dementia

Answer 10

Early personality disturbances
Mood changes
Cognitive impairment

Question 11

Mild cognitive impairment

Answer 11

Only 1 cognitive function affected

Increases risk of dementia

Question 12

Treatable causes of dementia

Answer 12

Hypothyroid
Normal pressure hydrocephalus
Thiamine deficiency
B12 / folate deficiency

Question 13

Wernicke’s encephalopathy

Answer 13

Reversible thiamine deficiency

Leads to Korsakoff’s psychosis of untreated

Question 14

Korsakoff’s psychosis

Answer 14

Permanent brain dysfunction

Due to thiamine deficiency

Question 15

Cause of thiamine deficiency

Answer 15

Chronic alcohol excess

Question 16

Mx of Alzheimer’s disease

Answer 16

Galantamine
Donepezil
Rivastigmine

Memantine - if severe

Question 17

Mx of Lewy Body dementia

Answer 17

Galantamine
Donepezil
Rivastigmine

Question 18

Galantamine

Answer 18

Cholinesterase inhibitor

Cognitive enhancer

Question 19

Donepezil

Answer 19

Cholinesterase inhibitor

Cognitive enhancer

Question 20

Rivastigmine

Answer 20

Cholinesterase inhibitor

Question 21

Memantine

Answer 21

Non-competitive glutamate NMDA receptor antagonist

Cognitive enhancer

Question 22

Delirium definition

Answer 22

Impaired conscious / cognition
Acute onset
Hallucinations
Impaired memory

Question 23

Causes of delirium

Answer 23

PINCH ME

Pain
Infection
Nutrition
Constipation
Hydration / Hypoxia

Medication
Environment

Question 24

Circumlocution

Answer 24

Saying many words where fewer are required

Talking around a subject because they can’t quite remember the word they want to say

Question 25

Confabulation

Answer 25

Memory impairment so fill in gaps with fabricated memories