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Year 2 C&M Clinical Symposia > Dementia Symposium > Flashcards

Dementia Symposium Flashcards

1
Q

How many thousand people in the UK are affected by dementia?

A

700,000

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2
Q

What percentage of over 65s and over 80s suffer from dementia?

A

over 65s - 5%

over 80s - 20%

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3
Q

In a typical district general hospital what percentage of patients have dementia?

A

over 20%

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4
Q

Abnormality in the frontal lobe leads to what 5 defects?

A

1) Impaired judgement
2) Impaired abstract reasoning and strategic planning
3) Impaired emotional restraint
4) Impaired control over appetite
5) Incontinence

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5
Q

Diseases of the parietal lobe give rise to what 2 things?

A

1) Impairment of visuospatial skills leading to apraxias

2) Impaired integration of sensory inputs leading to sensory agnosias

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6
Q

Diseases of the medial temporal lobe, hippocampus, amygdala and limbic system leads to what 2 features?

A

1) Disorders of memory

2) Hallucinations

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7
Q

Diseases of the temporal neocortex is associated with what 2 features?

A

1) Receptive dysphasia

2) Automatisms (performance of actions without concious thought)

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8
Q

Diseases of the occipital lobe leads typically to what?

A

Failure of the visual sensory systems

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9
Q

What 8 ‘treatable’ conditions can cause dementia?

A

1) Depression
2) Iatrogenic (anticholinergics, sedatives, narcotics, H2 blockers, multiple meds)
3) Hypothyroidism
4) B12 deficiency
5) Neurosyhpilis
6) Normal pressure hydrocephalus
7) Subdural hematoma
8) Encephalitis

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10
Q

Give the 4 main types of neurodegenerative dementias?

A

1) Alzheimer’s dementia
2) Lewy Body dementia
3) Frontotemporal dementia
4) Huntington’s disease (and many others)

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11
Q

What are the other 2 main types of dementias which are not classed as neurodegenerative dementias?

A

1) Vascular dementia

2) Prion disease

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12
Q

Can vascular dementia be treated?

A

Treatment can slow down progression but cannot cure

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13
Q

What is the prognosis of prior disease?

A

Untreatable but with rapid progression

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14
Q

In addition to type how else can dementias be classified?

A

By site - ie anterior/posterior, cortical/subcortical

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15
Q

How do the symptoms of anterior dementia tend to differ from posterior dementia?

A

Anterior - behaviour changes - ie loss of inhibition, antisocial etc.
Posterior - disturbance of cognitive function (memory and language) without marked changes in behaviour

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16
Q

What is the common site of Alzheimer’s disease?

A

Posterior cortical

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17
Q

Name 2 types of dementias which tend to be sub cortical?

A

1) Parkinson’s disease

2) AIDS dementia complex

18
Q

How do the symptoms of subcortical dementias tend to differ from cortical dementias?

A

Subcortical - apathetic, forgetful and slow, associated with other neurological signs and movement disorders
Cortical - Higher cortical abnormalities - dysphasia, agnosia, apraxia

19
Q

Traditionally, which 3 neurodegenerative disorders were classified as dementias (as opposed to movement disorders)?

A

1) Alzheimer’s disease
2) Frontotemproal dementia
3) Dementia with Lewy bodies

20
Q

Traditionally which 4 neurodegenerative disorders were classified as movement disorders (Rather than dementias)?

A

1) Parkinson’s disease
2) Parkinson plus syndromes (progressive supranuclear palsy, multiple system atrophy, corticobasal degeneration)
3) Huntington’s disease
4) Motor neuron disease

21
Q

What are the 3 current molecular-genetic classifications of neurodegenerative disorders?

A

1) Tauopathies
2) Synucleinopathies
3) Ubiquinopathies

22
Q

Which molecular genetic classification does Alzheimer’s disease fall into?

A

Tauopathies

23
Q

Which molecular genetic classification does Parkinson’s disease and Dementia with Lewy bodies fall into?

A

Synucleinopathies

24
Q

What 2 types of dementia fall under the classification of ubiquinopathies?

A

1) MND and MND/Dementia
2) Semantic dementia
(Both subtypes of frontotemporal dementia)

25
Q

Normal pressure hydrocephalus is a triad of which 3 symptoms occurring in conjunction with what?

A

1) Dementia
2) Gait disturbance
3) Urinary incontinence
Occurring in conjunction with hydrocephalus and normal CSF pressure

26
Q

What are the 2 types of normal pressure hydrocephalus (NPH)?

A

1) NPH with a preceding cause (SAH, meningitis, trauma, radiation induced)
2) NPH with no known preceding cause - idiopathic (50%)

27
Q

Why is CJD described as a transmissable spongiform encephalopathy?

A

Under a microscope, the affected brain tissue looks like a sponge

28
Q

How would an EEG appear in a person with CJD?

A

Triphasic waves - on repeat testing

29
Q

What would be the 2 typical symptoms of someone with CJD?

A

1) Rapid cognitive decline

2) Myoclonic jerks (quick involuntary muscle jerks)

30
Q

What would be the main feature of an MRI of a patient with sporadic CJD?

A

Non specific changes in the basal ganglia

31
Q

What is the characteristic abnormality in MRI in patient with variant CJD?

A

Abnormality in the posterior thalamic region - called pulvinar sign which is highly sensitive and specific for vCJD

32
Q

Corticobasal degeneration falls into which molecular genetic classfication?

A

Tauopathy

33
Q

What is the main feature corticobasal degeneration on electron microscopy?

A

Phospho-tau filaments with the neurons (also cytoplasmic tangles, neuropil threads)

34
Q

If a patient presents with fitting and ongoing confusion what is the most likely diagnosis?

A

Encephalitis

35
Q

Encephalitis due to Voltage gated postassium channel Ab (VGKC Ab LE) is what kind of encephalitis?

A

Autoimmune encephalitis

36
Q

What are the 4 common signs and symptoms of VGKC Ab LE)

A

1) Subacute memory loss
2) Psychiatric/behavioural disturbances
3) Seizures - usually partial
4) Hyponatraemia in common

37
Q

What sign do 60% of people with VGKC Ab LE shown on MRI?

A

Medial temporal lobe high signal on MRI

38
Q

Does VGKC Ab LE cause treatable or untreatable dementia?

A

Treatable dementia - type of autoimmune enecephalitis which can be treated with steroid treatment

39
Q

What is the prognosis of VGKC Ab LE?

A

Thymoma/SCLC (Small cell lung cancer) may also be present but isnt commonly associated
If no tumour is present then the prognosis is very good with immuno modulation

40
Q

What kind of conditions are neurologists mainly concerned with in regards to dementia?

A

Treatable conditions

41
Q

Which specialty deals with dementias caused by untreatable conditions?

A

Psychiatry

Year 2 C&M Clinical Symposia (21 decks)

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