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MS4 - Geriatrics > Dementia/Delirium > Flashcards

Dementia/Delirium Flashcards

1
Q

Dementia def

A

progressive global decline in intellectual and memory

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2
Q

Reversible causes of dementia

A 
normal pressure hydrocephalus
alcohol abuse
neurosyphillis
hypothyroid
Vit B12 deficiency
pseudo-dementia of depression
Neoplasms eg meningioma
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3
Q

Different types of memory

A 
Sensory
Short term (STM) 
Long term (LTM) : Semantic , episodic
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4
Q

Semantic memory

A

learned information

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5
Q

Episodic memory

A

persons experiences

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6
Q

Encoding

A

converson of STM to LTM

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7
Q

Dementia normally affects which type of memory

A

at early stages STM

later LTM

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8
Q

What is a sensory memory

A

visual auditory tactile taste

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9
Q

Irreversible causes of dementia

A

Alzheimers disease
Vascular dementia
Senile dementia of Lewy body type

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10
Q

Range of sx of AD

A 
Early stages: impairment of 
- judgement
- memory
- abstract thinking
Later stages: dintegeration of
- intellect
- personality 
- incoherence 
- incontinence
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11
Q

Which chromosomes ass with AD

A

1
14
21

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12
Q

Pathological findings in AD imaging

A

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

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13
Q

Pathological findings in AD post mortem

A

neurofibrillary tangles

senile plaques

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14
Q

Which neurotransmitter is depleted in AD

A

Ach

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15
Q

Diagnosis of AD

A

no single test

using CT findings + Hx

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16
Q

Meds to Rx AD

A

Cholinesterase inhibitors:

  • Galantamine
  • Donepezil
  • Rivastigmine
17
Q

Effectiveness of med mx of AD

A

works in half

effective only for 2-3 yrs

18
Q

Vascular dementia rx

A
  • modifying CVS risk factors may slow progression eg rx DM or HTN
  • ACEi/aspirin may help
19
Q

Vascular dementia def

A

mental impairment from cerbrovascular disease

20
Q

Difference between AD and vascular dementia progression

A 
vascular
- abrupt onset, episodic deterioration 
- cognitive impairment tend to be selective and uneven depending on the part affected 
AD
- slow progressive deterioration
- everything affected
21
Q

Senile dementia of the lewy body type (SDLT) def

A

histopathologically similar to AD and PD

but has Lewy Body in abundance

22
Q

SDLT features

A
  • progressive dementia
  • varying mental state and functional ability on a daily basis
  • could have features similar to PD (parkinson)
23
Q

SLDT Rx

A
  • Anti PD drugs help relieving sx

- poss Cholinergic agonists

24
Q

Driving with dementia

A
  • depends on the level, but advised against

- inform DVLA as last resort

25
Q

Meds causing of delirium

A 
O SAS 
opiates
sedatives
anticholinergics, anti PD meds, analgesics 
steroids
26
Q

Non med causes of delirium

A

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

27
Q

Test to differentiate delirium from dementia

A

CAM score (confusion assessment method)

28
Q

Main fx of delirium

A
  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)
29
Q

Cognitive function tests for delirium

A

AMT

MMSE

30
Q

Criteria for Dementia

A

At least 6 months
Affects ADLs
Exclude reversible causes

31
Q

Which gene protective of Alzheimer’s

A

ApoE-e2

32
Q

Which gene increases risk of Alzheimer’s

A

ApoE-e4

33
Q

TARDBP43 ass with which dementia

A

Fronto-temporal

34
Q

Normal pressure hydrocephalus

A

ataxia
urinary incontinence
dementia

35
Q

MMSE score interpretation

A

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

36
Q

Pellagra

A

dementia
dermatitis
diarrhoea

37
Q

Pellagra cause

A

Vit B3 deficiency

MS4 - Geriatrics (10 decks)

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