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Psychiatry - Chloe > Dementia/congenital impairment > Flashcards

Dementia/congenital impairment Flashcards

0
Q

What is dementia?

A

Global impairment of cognitive function and personality without impairment of consciousness

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1
Q

When is dementia consider early onset?

A

Before the age of 65

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2
Q

How long do symptoms of dementia have to be present for a diagnosis of dementia to be made?

A

6 months

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3
Q

What is the most common cause of dementia?

A

Alzheimer’s disease

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4
Q

What drugs may be used to slow the progress of Alzheimer’s disease?

A

ACh inhibitors

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5
Q

What drugs can cause a Parkinsonian reaction in Lewy Body dementia?

A

Antipsychotics

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6
Q

Name the dementia

Uneven or stepwise deterioration in cognitive function

A

Vascular

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7
Q

Name the dementia

Spontaneous motor signs of Parkinson’s (rigidity/ bradykinesia/ tremor)

A

Lewy body

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8
Q

Name the dementia

Evidence of CVD/ stroke

A

Vascular dementia

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9
Q

Name the dementia

Early decline in social and personal conduct ( disinhibition/ tactless)

A

Frontotemporal (picks)

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10
Q

Name the dementia

Decreased speech output, echolalia, perseveration, mutism

A

Front temporal

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11
Q

Gradual onset with cognitive decline, other dementia are excluded

A

Alzheimer’s

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12
Q

Transient disturbances of consciousness with recurrent visual hallucinations

A

Lewy body

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13
Q

What is agnosia?

A

Can’t name objects

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14
Q

What are the main differences between delerium and dementia?

A

Delerium is an acute onset with a fluctuating progression and there is impaired consciousness where in dementia there is no impaired consciousness
Also I delerium there is perceptual disturbance and impaired sleepwalker cylcle - not so much in dementia

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15
Q

What is a perceptual disturbance?

A

Misinterpretation
Illusion
Hallucination

A scale between the 3

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16
Q

What variable are tested in a cognitive function test?

A 
Orientatation
Attention and concentration
Memory 
Language 
Construction
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17
Q

What is a catastrophic reaction?

A

Reaction to a test where patient may get upset and refuse to go on with the test

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18
Q

What is the prevalence if dementia?

What is the prevalence in those over 90?

A

1 in 85

35%

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19
Q

What is the life expectancy of someone with Alzheimer’s?

A

5-8 years

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20
Q

What is pseudo dementia?

A

When you have really severe depression that starts to cause dementia

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21
Q

What is nominal dysphasia?

A

Can describe object but not name it

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22
Q

How severe is the dementia that is sufficient to interfer with ADLs but can still live independently?

A

Mild

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23
Q

Define the 4 ICD symptoms of dementia

A

Decline in memory
Decline in cognitive functions (judgement, thinking, planning)
Decline in emotional control/ behaviour
Damage to higher cortical functions (aphasia, agnosia, apraxia)

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24
Q

Name some other causes of deme tail other than the obvious 4

A 
CJD
Huntingtons
HIV
Parkinson's 
Alcohol
Vit B12 def
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25
Q

What are pick cells?

What are pick bodies?

A

Ballooned neurones

Tau/ubiquitin protein bodies

26
Q

What are the three types of fronto temporal dementia?

A
  • behavioural variant
  • progressive non fluent aphasia
  • semantic
27
Q

What is behavioural variant FTD?

A

Frontal love involvement predominates leading to changes in personality/ behaviour

28
Q

What is progressive non-fluent aphasia?

Which love predominates?

A

Temporal lobe leading to loss of language skills either in production or understanding

29
Q

What is fronto temporal semantic dementia?

A

Loss of semantic memnoryy - knowledge of things and concepts

30
Q

Is someone with fronto temporal dementia likely to have insight?

A

No

31
Q

What test can you use to test for perseveration?

A

Rhythmic tapping tasks - I tap once you tap twice

32
Q

Why would a CT show is frontotemporal dementia?

A

Frontotemporal atrophy

Also “knife blade atrophy”

33
Q

How does the Lewy body dementia differ with picks histology ally

A

Lewy bodies and plaques but few fibrillary tangles in Lewy body

34
Q

Where are the Lewy bodies in Parkinson’s and LBD?

A

LBD - cortex, hippocampus

Parkinson’s - midbrain/ substansia nigra

35
Q

What is the difference between 1) “dementia with Lewy bodies” and 2) “Parkinson’s disease dementia”?

A

You have movement disorder then
Cognitive impairement
1) within a year
2) more than a year later

36
Q

What are Lewy bodies?

A

Deposits of protein (alpha synuclein) within nerve cells

37
Q

Is Lewy body dementia more common in males or females?

A

Females

38
Q

What are the three core features of Lewy body dementia?

A

Fluctuating cognition
Motor features of Parkinson’s
Visual hallucinations

39
Q

Name the dementia

Recurrent falls, syncope, LOC

A

Lewy body dementia

40
Q

What are the five As of Alzheimer’s?

A 
Amnesia
Aphasia
Agnosia
Apraxia
Associated behaviours - bpsd
41
Q

What does bpsd stand for?

A

Behavioural and psychological symptoms in dementia

42
Q

Give examples of cortical dementia?

A

Alzheimer’s
Vascular
Frontotemporal

43
Q

Give examples of sub cortical dementia

A

Parkinson’s
Huntingtons
Progressive supra nuclear palsy

44
Q

What is the difference between cortical and sub cortical dementia?

A

??
Cortical often has focal cognitive impairment - memory, language, problem solving
Sub cortical - psychomotor slowing

45
Q

In Alzheimer’s what are present in he cortex and hippocampus?

A

Neurofibrilary tangles

Amyloid plaques

46
Q

What genetic factors predispose to late onset Alzheimer’s?

A

Appoliprotein E4 (ApoE)

47
Q

What genetic factors influence early onset Alzheimer’s?

What is the pattern of inheritance?

A

Prenesillin 1 and 2

Autosomal dominant

48
Q

What are the risk factors for vascular dementia?

A

Hypertension
High cholesterol
Diabetes
Smoking

49
Q

Normal pressure hydrocephalus can cause dementia, what features does this have?

A

Patchy dementia
Marked mental slowness apathy
Wide based gait
Urinary incontinance

50
Q

In an old person with memory problems what might you want to rule out?

A

Depression - severe depression can cause memory loss

51
Q

Name some anticholinesterases

A

Donepezil, rivistigmine, galantamine

52
Q

When should anticholinesterases be used?

A

In mild to moderate Alzheimer’s/ Lewy body

53
Q

What is memantine?

A

Modulates glutamine transmission

54
Q

What is memantine used for?

A

Moderate to severe Alzheimer’s

55
Q

What has a worse prognosis Alzheimer’s or vascular?

A

Vascular

56
Q

What is the average length of delerium?

A

7days

57
Q

What drugs can be used in Alzheimer’s dementia?

A

Acetylcholinesterase inhibitors

Memantine

58
Q

How does memantine work?

A

Glutamate receptor antagonist

59
Q

Name some ACh esterase inhibitors

A

Donepezil, galantamine, rivistigmine

60
Q

What is there a risk of if a person is on both Donepezil and an antipsychotic?

A

Neuroleptic malignant syndrome

61
Q

What factors assessed when assessing cognition?

A 
Orientation (time, place, person)
Concentration/ attention 
Memory 
Language 
Construction
62
Q

What are the 5 A’s of Alzheimer’s?

A 
Amnesia
Apraxia 
Aphasia
Agnosia
Associated behaviours / psych conditions
63
Q

What groups of people is Alzheimer’s screened for?

A

Down’s syndrome
Post stroke
Parkinson’s disease

Psychiatry - Chloe (11 decks)

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