Dementias Flashcards
What is confusion?
- lack of clarity in thinking
- everyday issues can be challenging
What is cognition?
- the mental process involved in making sense of and learning about the world around us
What is crystallised cognitive ability?
- cumulative skills and memories from cognitive processing that occurred in the past
- tests of general knowledge, vocabulary, reading comprehension, maths, science
What is ‘fluid’ cognitive ability?
- processing of new information to quickly solve problems
In ageing does crystallised and fluid cognitive abilities decline equally?
- no
- fluid declines
- crystallised typically remains
- fluid has a more dramatic decline
Which of the following are common conditions where a healthy individual may experience cognitive impairment?
1 - alcohol/drugs
2 - acute illness
3 - sleep deprivation
4 - extreme exercise
5 - all of the above
5 - all of the above
What is dementia (which is an umbrella term) latin for out of ones mind?
1 - generalised decline in intellect
2 - generalised decline in memory and personality
3 - unaltered consciousness
4 - functional impairments
5 - all of the above
5 - all of the above
- it is commonly described as a syndrome rather that a diagnosis in itself
- group of progressive, neurodegenerative brain disorders
When we talk about dementia, what is one of the key attributes for it to be called dementia, regarding the symptoms?
1 - progressive worsening of symptoms over time
2 - rapid onset of symptoms
3 - rapid onset and then slow progression
4 - slow progression with intermittent rapid deterioration of symptoms
1 - progressive worsening of symptoms over time
What are some of the common signs of dementia?
1 - muscle pain, stiffness, impaired memory, thinking and behaviour
2 - impaired memory, thinking and behaviour and altered ADL
3 - insomnia, hyper-mania and and altered ADL
4 - depression, elation and impaired memory and thinking
ADL = activities of daily living
2 - impaired memory, thinking and behaviour and altered ADL
Do patients with dementia typically have insight into their condition?
- no
What is the prevalence of dementia worldwide?
1 - 400,000
2 - 4 million
3 - 45 million
4 - 500 million
3 - 45 million
Are men or women more likely to get dementia?
- men
- 4 x more likely
What is the prevalence of dementia in the 65-69 year olds?
1 - 1:10
2 - 1:100
3 - 1:1000
4 - 1:10,000
2 - 1 in 100
What is the prevalence of dementia in the 70-79 year olds?
1 - 1:10
2 - 1:25
3 - 1:100
4 - 1:500
2 - 1 in 25
What is the prevalence of dementia in the >80 year olds?
1 - 1:6
2 - 1:25
3 - 1:100
4 - 1:500
1 - 1 in 6 people
How many people in the Uk are living with dementia, and what is the estimated cost of this per year?
- 850,000 people
- £34.7 billion per year
What is the primary reason the incidence of dementia is increasing?
1 - poor health care
2 - waiting too long for treatments
3 - polypharmacy
4 - ageing population
4 - ageing population
Which of the following is the leading cause of disability in later life in the UK?
1 - CVD
2 - dementia
3 - cancer
4 - stroke are leading
2 - dementia
Diagnosing a patient with dementia is made more difficult by depression pseudodementia. Which of the following are typical characteristics?
1 - depressed mood preceding memory issues
2 - memory tests improve with increased arousal
3 - psychomotor retardation
3 - impaired intellect and concentration
4 - unwilling to cooperate with consultations
5 - all of the above
5 - all of the above
When we are looking to diagnose dementia, we come up with a list of differentials. Which of the following is NOT commonly a differential?
1 - psychosis
2 - depression
3 - delirium
4 - migraines
4 - migraines
When we compare dementia and delirium, which has rapid onset and which has a gradual development over time?
- rapid onset = delirium
- gradual decline = dementia
Dementia is an umbrella term covering a number of neurodegenerative brain conditions. Which is the most common?
1 - Parkinsons disease
2 - Lewy body dementia
3 - Alzheimers disease
4 - Vascular dementia
3 - alzheimers disease
Dementia is an umbrella term covering a number of neurodegenerative brain conditions. The most common is Alzheimers, what is the second most common cause?
1 - Parkinsons disease
2 - Lewy body dementia
3 - Frontal-Temporal dementia
4 - Vascular dementia
4 - vascular dementia
- closely followed by Lewy body dementia
- dementia caused by cerebrovascular disease
What is alpha synuclein?
1 - protein found inside neurons, maintains microtubule structure
2 - protein aggregates that form extracellular plaques in the brain
3 - protein in brain involved in synaptic trafficking and neurotransmitter release
4 - protein found outside neurons, maintains pre-synapse
3 - protein in brain involved in synaptic trafficking and neurotransmitter release
How can a-synuclein, a normal protein in the brain that is involved in synaptic vesicles trafficking and regulation of neurotransmitter release cause lewy bodies?
1 - clump together forming plaques that build up around synapses causing neuronal cell death
2 - mis-folded form of a-synuclein aggregate around synapse causing neuronal cell death
3 - excessive levels inhibit neurotransmitter release despite action potential
4 - binds to vesicles and inhibits vesicle binding to pre-synapse membrane
2 - mis-folded form of a-synuclein aggregate around synapse causing neuronal cell death
- the aggregates of misfolded protein are called Lewy bodies
- lewy bodies can cause neurons to die
There are 2 types of dementia (that we need to know about) that are associated with lewy bodies (misfolded a-synuclien), what are these?
1 - Parkinsons disease dementia and dementia with lewy bodies
2 - Lewy body dementia and Alzheimers disease
3 - Alzheimers disease and Parkinsons disease
4 - Vascular dementia and Lewy body dementia
1 - Parkinsons disease dementia and dementia with lewy bodies
Most dementias are caused by a misfolding of different proteins. What are the 3 main proteins we need to be aware of?
1 - Tau protein, a-synuclein, B-Amyloid
2 - SMN-1 protein, a-synuclein, B-Amyloid
3 - Tau protein, a-synuclein, SMN-1 protein
4 - Tau protein, SMN-1 protein, B-Amyloid
1 - Tau protein, a-synuclein, B-Amyloid
Tau protein is a protein located in the brain. What is one of the key roles of Tau protein?
1 - stabilisation of the internal microtubules
2 - regulation of vesicle trafficking at synapse and neurotransmitter release
3 - regulate neurotransmitter trafficking to and from nucleus
4 - ensure vesicles bind with pre-synaptic membrane
1 - stabilisation of the internal microtubules
- essentially hold together the microtubules
- important for neurogenesis
Organise the following, which explain the pathology of Tau proteins?
1 - phosphorylation of Taus clump together
2 - kinase adds phosphate to Tau proteins
3 - Beta amyloid plaques signal neuron
4 - kinase is activated
5 - microtubules become less stable and neuronal signalling is impaired
2 - Beta amyloid plaques signal neuron
4 - kinase is activated
2 - kinase adds phosphate to Tau proteins
4 - microtubules become less stable and neuronal signalling is impaired
1 - phosphorylation of Taus clump together
What is amyloid precursor protein?
1 - protein located within neuronal cell bodies
2 - protein receptor located on neuronal cell bodies
3 - protein located across neuronal membranes (half inside and half outside)
4 - protein located in dendrites
3 - protein located across neuronal membranes (half inside and half outside)
Amyloid precursor protein is protein located across neuronal membranes (half inside and half outside). What is the function of this protein?
1 - aids growth of neurons
2 - repairs neurons
3 - synapse plasticity
4 - all of the above
4 - all of the above