Dementia And Management Flashcards
What is the neumonic for reversible causes of cognitive impairment ?
VINDICATE
What are the reversible causes of cognitive impairment?
Vascular Infection, inflammation Neoplasms Drugs, degenerative Iatrogenic, idiopathic Congenital/ inherited/ developmental Autoimmune, allergy, anatomical Trauma Endocrine, environmental
Clinical features of Alzheimer’s disease?
Memory loss- particularly short term
Dysphasia
Dyspraxia
Agnostic
In Alzheimer’s, what is seen on CT/MRI?
Normal Or Medial temporal lobe atrophy Or Temporoparietal atrophy
Features of vascular dementia
Dysphasia Dyscalculia Frontal lobe symptoms May have focal neurological signs May have vascular risk factors
Features of vascular dementia on CT/MRI
Moderate - severe small vessel disease
Multiple lacunae infarcts
Results of SPECT for Vascular dementia?
Patchy reduction in tracer uptake throughout the brain
What are the 3 syndromes of frontotemporal dementia?
Behavioural variant
Primary progressive aphasia
Semantic dementia
Features of frontotemporal dementia on CT/MRI?
Frontotemporal atrophy
Result of frontotemporal dementia on SPECT?
Decrease in tracer uptake in frontotemporal lobe
Features of behavioural variant?
Behavioural changes Disinhibition Impulsivity Loss of social skills Apathy Obsession Change in Diet
Features of primary progressive aphasia
Non-fluent speech
Speech sound/ articulatory errors
Lack of grammar
Lack of words
Features of semantic dementia
Impaired understanding of meaning of words
Fluent but empty speech
Difficulty retrieving names
What are cholinesterase inhibitors used for?
Alzheimer’s- donepezil; rivastigmine, galantamine
Dementia with Lewy bodies - rivastigmine
Any contraindications yo cholinesterase inhibitors?
Not with an active peptic ulcer
Not with severe asthma or COPD
