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Clinical Neuroscience > Dementia & Delirium > Flashcards

Dementia & Delirium Flashcards

1
Q

Name the 5 types of dementia.

A 
Alzheimer's disease
Vascular dementia
Dementia with Lewy Bodies
Frontotemporal dementia
AIDS dementia complex
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2
Q

What is the main difference between dementia and delirium?

A

Someone with dementia has clear consciousness - they are not confused and are alert, whereas someone with delirium is confused.

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3
Q

What is dementia?

A

A syndrome with cognitive and behavioural decline, usually caused by brain death/damage.

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4
Q

What are the 2 types of dementia symptoms?

A

Cognitive

Non-cognitive

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5
Q

State some cognitive symptoms for dementia.

A

Depends on which area of the brain is affected:

  • temporal - memory impairment
  • parietal - visual impairment
  • frontal - impaired learning and judgement
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6
Q

State some non-cognitive symptoms for dementia.

A
  • behavioural - agitation, aggression, sexual disinhibition
  • mood - depression, anxiety
  • psychosis - visual and auditory hallucinations, persecutory delusions
  • sleep - insomnia, daytime drowsiness
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7
Q

Name the 3 things that means a diagnosis of dementia is likely.

A
  • cognitive decline
  • impairment to do daily activities
  • clear consciousness
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8
Q

Name some symptoms of hypercalcaemia.

A

Moans - depression
Groans - GI pain
Stones - renal

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9
Q

What is sexual disinhibition?

A

Loss of ability to know what is appropriate, it is a common non-cognitive symptom of dementia.

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10
Q

State 3 macroscopic changes with Alzheimer’s disease.

A
  • Sulcal widening
  • global brain atrophy
  • enlargement of 3rd and 4th ventricles
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11
Q

What is Alzheimer’s disease?

A

A type of dementia where neuronal death leads to a decrease in neurotransmitter at synapses.

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12
Q

Name 2 microscopic changes of Alzheimer’s disease.

A
  • senile plaque - aggregates of amyloid formed by abnormal breakdown of amyloid precursor protein
  • neurofibrillary tangles - hyperphosphorylated tau proteins
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13
Q

What is vascular dementia?

A

Cognitive impairment caused by ischaemia or haemorrhage secondary to cerebrovascular disease.

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14
Q

State some risk factors for vascular dementia.

A
  • hypertension
  • diabetes
  • smoking
  • hypercholesterolaemia
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15
Q

Which type of dementia is associated with Parkinson’s disease?

A

Dementia with Lewy bodies

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16
Q

What is a Lewy body?

A

Abnormal aggregation of alpha-synuclein protein in the cytoplasm of a cell.

17
Q

What is Lewy Body dementia?

A

When Lewy bodies are deposited in the frontal and temporal lobes, substantia nigra and cingulate gyrus, leading to cognitive symptoms and Parkinsonian features.

18
Q

State some symptoms of dementia with Lewy bodies.

A
  • vivid visual hallucinations
  • features of Parkinsonism
  • sensitive to neuroleptic malignant syndrome
19
Q

What is neuroleptic malignant syndrome?

A

When there is a sudden drop in dopamine as a side effect of antipsychotics. Symptoms remembered as FEVER.

20
Q

What are the symptoms of neuroleptic malignant syndrome?

A

F - fever
E - encephalopathy
V - vital signs instability - tachycardia, tachypnoea
E - elevated creatine phosphokinase enzyme level
R - rigidity

21
Q

What is frontotemporal dementia?

A

When atrophy of the frontal and temporal lobes occurs, leading to dementia (common cause of early onset dementia).

22
Q

Name some symptoms specific to frontotemporal dementia.

A
  • inappropriate social behaviour

- non-fluent aphasia (difficulty articulating speech)

23
Q

What is AIDS dementia complex?

A

When an HIV infected macrophage enters the brain and damages neurones, leading to cognitive impairment, tremor, ataxia, dysarthria etc.

24
Q

How can the AIDS dementia complex be managed?

A
  • Acetylcholinesterase inhibitors - reduces ACh breakdown in synaptic cleft, increasing neurotransmission
  • NMDA antagonists - reduces overstimulation of glutamate, which can cause aggression.
25
Q

What is delirium?

A

When insult to the brain caused by hypoxia or inflammation leads to acute neuronal cell death.

26
Q

What are the 2 types of delirium?

A

Hypoactive - withdrawn, quiet, sleepy

Hyperactive - restless, agitated, aggressive

27
Q

Name some causes of delirium.

A
  • extracranial infections e.g. UTI, pneumonia, sepsis
  • intracranial trauma or infection
  • alcohol withdrawal
  • vitamin B12 or folate deficiency
  • renal or hepatic failure
28
Q

What is the management of delirium?

A

Treat the underlying cause.

29
Q

If left untreated, what is the prognosis of delirium?

A

Increased risk of dementia.

Clinical Neuroscience (10 decks)

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