Demetia And Delirium Flashcards
What is dementia?
It is a syndrome (a collection of symptoms) with cognitive and behavioural symptoms
It has an insidious onset (patient don’t know have it)
Chronic with slow deterioration (progressive)
What are the cognitive symptoms of dementia?
The symptoms the patient experiences depends on the the lobe(s) of the brain affected.
Impairment of memory (temporal)
Orientation (parietal)
Learning capacity (frontal)
Judgement (frontal)
What are the non-cognitive symptoms of Demetria?
Behavioural symptoms:
Agitation and Aggression (don’t know where they are)
Wandering
Sexual disinhibition (frontal lobe)
Psychotic:
Visual and Auditory Hallucinations
Persecutory dellusions
Depression and anxiety
Sleep symptoms:
Insomnia
Daytime Drowsiness
How do you diagnose dementia?
It is a diagnosis of exclusion
What things do you have to exclude to diagnose dementia?
Hypothyroidism
Hypercalcaemia
B12 deficiency
Normal pressure hydrocephalus
How diagnose demetia?
Cognitive decline
Resulting impairment in activities of daily living
Clear consciousness
What are some types of dementia?
Alzheimer’s Disease
Vascular demetia
Dementia with Lewy bodies
AIDS Dementia complex.
What macroscopic changes occur with Alzheimer’s disease?
Global atrophy
Sulcal widening
Enlarged ventricles (3rd and 4th)
What microscopic changes occur with Alzheimer’s disease?
Senile plaques (AB protein)- Amyloid precursor protein (APP) broken down to AB protein
Neurofibrillary tangles - Hyperphospholylated Tau proteins.
Causes: Neuronal death.
Decrease: ACh, NA, 5HT, Somatostatin
What is vascular dementia?
Cognitive impairment caused by ischaemia or haemorrhage secondary to cerebrovascular disease.
Pathologically = at least one area of cortical infarction
What are the risk factors for vascular demetia?
Stroke, hypertension, hypercholesterolaemia, diabetes, smoking
To treat: treat risk factors
How does vascular dementia present?
Stepwise (sudden decrease in cognitive impairment)
Focal neurological symptoms. -Symptoms depends on where the lesion is.
What is a Lewy Body?
Aggregation of a-synuclein protein
Spherical
Intracytoplasmic deposition
Where are Lewy Bodies deposited in dementia?
Substantia Nigra
Temporal lobe
Frontal lobe
Cingulate Gyrus
How does LBD present?
Fluctuating cognition and alertness Vivid visual hallucinations Spontaneous features of Parkinsonism. Repeated falls (shuffling gait) Sensitive to neuroleptic malignant syndrome. -So no anti-psychotics in LBD.