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Leeds MBCHB Year 4 Psychiatry > Dementia and Parkinson's > Flashcards

Dementia and Parkinson's Flashcards

1
Q

Classic triad of Parkinsons

A

Resting tremor
Bradykinesia
Rigidity

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2
Q

Parkinsons pathophysiology

A

Reduction of dopamine in basal ganglia

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3
Q

How do symptoms present in Parkinsons (not the specific symptoms)

A

Asymmetrically

One side is normally worse than the other

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4
Q

What is basal ganglia responsible for

A

Coordinating movements

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5
Q

Where is the substantial nigra and what does it do

A

Part of the basal ganglia that produce dopamine

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6
Q

Typical demographics of a parkinsons patient

A

70M

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7
Q

Describe Parkinsonian tremor and how it may change

A

4-6hz - pill rolling

Tremor is worsened if patient is distracted
For example asking them do a movement in the other hand

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8
Q

How is a benign essential tremor affected at rest

A

Improves

Parkinson’s worsens at rest but improves with intentional movement

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9
Q

How does a benign tremor change with alcohol

A

Improves

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10
Q

What type of dementia is associated with Parkinsons

A

Lewy body

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11
Q

Key drugs for Parkinsons and how do they work

A

Co-……..-Dopa

Synthetic dopamine with a decarboxylase inhibitor to stop domaine being broken down

Can also use COMT inhibitors, dopamine agonists (pulmonary fibrosis), and monoamine oxidase B inhabitors

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12
Q

Drug of choice for delirium tranquillisation

A

Haloperidol

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13
Q

Memory loss features in dementia

A

Short term more effected than long term

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14
Q

5 key types of dementia

A

AD
D with Lewy bodies
Huntingtons
Picks disease and frontotemporal

Vascular
(Other secondary causes)

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15
Q

Most common form of dementia

A

AD (50%)

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16
Q

Risk factors for AD

A

Female sex
FH
Downs syndrome
Head injury

17
Q

Key pathophysiology of AD

A

Formation of amyloid plaques
Cortical atrophy
Senile plaques and neurofibrillary tangles

18
Q

Second most common cause of Dementia

A

D with Lewy bodies (20%)

19
Q

What are Lewy bodies

A

Alpha-synuclein cytoplasmic inclusions

20
Q

Key feature for Lewy body dementia

A

Early impairments in attention (rather than just memory in comparison to AD)

Features of Parkinson’s
Visual hallucinations

21
Q

Type of scan to diagnose Lewy body dementia

A

SPECT scan

22
Q

What drugs should be avoided in a patient with Lewy body dementia having visual hallucinations

A

Anti-psychotics!!

Acetylcholinesterase inhibitors (e.g. donepezil, rivastigmine) and memantine can be used as they are in Alzheimer’s

23
Q

Drug treatment for Lewy body dementia

A

Acetylcholinesterase inhibitors (e.g. donepezil, rivastigmine) and memantine can be used as they are in Alzheimer’s

24
Q

NICE recommended assesment tool for cognitive impairment and dementia screening

A

10-CS (cognitive screen)

GPCOG and MMSE (score of less than 24/30)

25
Q

Risk factors for Picks disease

A

Age 45-60 years
Female
Scandinavian?

26
Q

Neuropathology changes since in Picks disease

A

‘knife blade’ atrophy affecting frontal and temporal lobes

Pick bodies

27
Q

Clinical features of Picks disease

A

Frontotemperal dementia

Insidious and progressive dementia with very prominent personality changes

hyperorality (examine objects by mouth), disinhibition and increased appetite

28
Q

Commonest cause of delirium

A

Drugs (not infection!)

29
Q

Key way to differentiate delirium and dementia

A

Consciousness (impaired in delirium)
Onset time
Course (delirium fluctuates)

30
Q

1st line class of drug in AD and DLB

A

Cholinesterase inhibitor (donepezil, rivastigmine galantamine)

31
Q

What is Picks disease

A

FT dementia

32
Q

Which type of dementia is the most rapidly progressing

A

DLB

Death common within 7 years

33
Q

visual hallucinations and Parkinson-like symptoms -> dx

A

DLB

34
Q

Differentiating DLB with Parkinsons

A

Parkinsons physical symptoms come first

35
Q

Dementia under 65 -> dx

A

FT dementia

CJD

36
Q

What dementia is associated with MND

A

FT

37
Q

Dementia most associated with visual hallucinations

A

DLB

Can be in late vascular

38
Q

rapid onset dementia and myoclonus

A

CJD

Leeds MBCHB Year 4 Psychiatry (11 decks)

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