Dementias

Question 1

What is Pick’s disease?

Answer 1

Frontotemporal dementia - a rare form of progressive dementia, typically in late middle age and often familial, involving localized atrophy of the brain

Question 2

What are the characteristic features of normal pressure hydrocephalus?

Answer 2

Urinary incontinence Dementia Gait abnormalities

Question 3

Which gender is more commonly affected by alzheimers?

Answer 3

Females

Question 4

What is the most common dementia in the UK?

Answer 4

Alzheimers disease

Question 5

What is the pathophysiology of Alzheimers disease?

Answer 5

Build up of amyloid plaques and neurofibrillary tangles on the brain

The accumulation of these leads reduction in transmission of information, and eventually to death of brain cells, with abnormal depositions remaining post-mortem

Question 6

What are amyloid plaques?

Answer 6

Clumps of beta amyloid and degenerating bits of neurons and other cells which lurk in between nerve cells

Question 7

What are neurofibrillary tangles?

Answer 7

Bundles of twisty filaments within neurons, mostly made from tau protein

Question 8

What are the symptoms of Alzheimers disease?

Answer 8

Gradual progression of memory loss, with evidence of varying changes in planning, reasoning, speech and orientation

Question 9

What is the second most common type of dementia?

Answer 9

Vascular dementia

Question 10

What areas of the brain are most commonly affected by vascular dementia?

Answer 10

The white matter of both cerebral hemispheres, grey nuclei, thalamus and the striatum

Question 11

What are the risk factors for vascular dementia?

Answer 11

Hypertension (main risk factor)

Smoking

Diabetes

Hyperlipidaemia

Obesity

Hypercholesterolaemia

Question 12

What is the pathophysiology of vascular dementia?

Answer 12

Multiple (commonly small) cerebrovascular infarcts, small vessel disease and a single cerebrovascular accident

Question 13

Which area of the brain is affected first in Alzheimer’s disease?

Answer 13

Nucleus basalis of Meynert

Question 14

What is the nucleus basalis of Meynert?

Answer 14

The main source of the cholinergic projections to the rest of the brain

Question 15

What is galantamine?

Answer 15

A cholinesterase inhibitor

Question 16

What percentage of cases of early onset Alzheimers have a genetic implication?

Answer 16

5-10% due to autosomal dominant trait

Question 17

What is the association with Down’s syndrome and dementia?

Answer 17

Alzheimers disease onset in 3rd or 4th decade of life

Question 18

What genes are implicated in early onset Alzheimer’s?

Answer 18

APP mutations (chromosome 21)

Presenilin 1 (chromosome 14)

Presenilin 2 (chromosome 1)

Question 19

What is the association between Apolipoprotein E and Alzheimer’s disease?

Answer 19

e4 allele predisposes to Alzheimers

Question 20

Which gender is more commonly affected by Lewy Body dementia?

Answer 20

Males

Question 21

At what age are people affected by Lewy Body dementia?

Answer 21

Over 50

Question 22

What is the diagnosis if physical decline occurs faster than cognitive in Lewy body dementia?

Answer 22

Parkinson’s disease with superimposed dementia

Question 23

What are the symptoms of Lewy Body dementia?

Answer 23

Visual hallucinations

Parkinson’s symptoms

Problems multitasking or complex cognitive tasks

Sleep disturbance

Question 24

What is the life expectancy post-diagnosis of Lewy Body dementia?

Answer 24

7 years