Dementia/Delirium

Question 1

Dementia def

Answer 1

progressive global decline in intellectual and memory

Question 2

Reversible causes of dementia

Answer 2

normal pressure hydrocephalus
alcohol abuse
neurosyphillis
hypothyroid
Vit B12 deficiency
pseudo-dementia of depression
Neoplasms eg meningioma

Question 3

Different types of memory

Answer 3

Sensory
Short term (STM) 
Long term (LTM) : Semantic , episodic

Question 4

Semantic memory

Answer 4

learned information

Question 5

Episodic memory

Answer 5

persons experiences

Question 6

Encoding

Answer 6

converson of STM to LTM

Question 7

Dementia normally affects which type of memory

Answer 7

at early stages STM

later LTM

Question 8

What is a sensory memory

Answer 8

visual auditory tactile taste

Question 9

Irreversible causes of dementia

Answer 9

Alzheimers disease
Vascular dementia
Senile dementia of Lewy body type

Question 10

Range of sx of AD

Answer 10

Early stages: impairment of 
- judgement
- memory
- abstract thinking
Later stages: dintegeration of
- intellect
- personality 
- incoherence 
- incontinence

Question 11

Which chromosomes ass with AD

Answer 11

1
14
21

Question 12

Pathological findings in AD imaging

Answer 12

atrophy (esp hippocampus) + enlarged lateral ventricles/widened sulci

Question 13

Pathological findings in AD post mortem

Answer 13

neurofibrillary tangles

senile plaques

Question 14

Which neurotransmitter is depleted in AD

Answer 14

Ach

Question 15

Diagnosis of AD

Answer 15

no single test

using CT findings + Hx

Question 16

Meds to Rx AD

Answer 16

Cholinesterase inhibitors:

• Galantamine
• Donepezil
• Rivastigmine

Question 17

Effectiveness of med mx of AD

Answer 17

works in half

effective only for 2-3 yrs

Question 18

Vascular dementia rx

Answer 18

• modifying CVS risk factors may slow progression eg rx DM or HTN
• ACEi/aspirin may help

Question 19

Vascular dementia def

Answer 19

mental impairment from cerbrovascular disease

Question 20

Difference between AD and vascular dementia progression

Answer 20

vascular
- abrupt onset, episodic deterioration 
- cognitive impairment tend to be selective and uneven depending on the part affected 
AD
- slow progressive deterioration
- everything affected

Question 21

Senile dementia of the lewy body type (SDLT) def

Answer 21

histopathologically similar to AD and PD

but has Lewy Body in abundance

Question 22

SDLT features

Answer 22

• progressive dementia
• varying mental state and functional ability on a daily basis
• could have features similar to PD (parkinson)

Question 23

SLDT Rx

Answer 23

• Anti PD drugs help relieving sx

- poss Cholinergic agonists

Question 24

Driving with dementia

Answer 24

• depends on the level, but advised against

- inform DVLA as last resort

Question 25

Meds causing of delirium

Answer 25

``` O SAS opiates sedatives anticholinergics, anti PD meds, analgesics steroids ```

Question 26

Non med causes of delirium

Answer 26

Infection Pain Retention (urine/faeces) Withdrawal (alcohol, benzodiazepine)

Question 27

Test to differentiate delirium from dementia

Answer 27

CAM score (confusion assessment method)

Question 28

Main fx of delirium

Answer 28

1. Acute (hrs-days) or fluctuating 2. Inattention (diff maintaining conversation) 3. and either - altered consciousness (reduced awareness of surroundings) - or disordered thinking ( speech disordered)

Question 29

Cognitive function tests for delirium

Answer 29

AMT | MMSE

Question 30

Criteria for Dementia

Answer 30

At least 6 months Affects ADLs Exclude reversible causes

Question 31

Which gene protective of Alzheimer's

Answer 31

ApoE-e2

Question 32

Which gene increases risk of Alzheimer's

Answer 32

ApoE-e4

Question 33

TARDBP43 ass with which dementia

Answer 33

Fronto-temporal

Question 34

Normal pressure hydrocephalus

Answer 34

ataxia urinary incontinence dementia

Question 35

MMSE score interpretation

Answer 35

<10 severe dementia 10-20 modereate <26 mild dementia

Question 36

Pellagra

Answer 36

dementia dermatitis diarrhoea

Question 37

Pellagra cause

Answer 37

Vit B3 deficiency