Extras Flashcards
Histopathology in Alzheimer’s?
Beta-amyloid plaques and neurofibrillary tangles made of tau protein.
What should you always consider in an acute presentation of a patient with chronic alcohol use?
Hypoglycaemia - check glucose!
What is seen on an MRI in vascular dementia?
Extensive white matter changes and infarcts
Give the MMSE scores for:
a) mild
b) mod
c) severe dementia
a) 21-26
b) 10-20
c) <10
Mx of normal pressure hydrocephalus?
1) Do an LP - see if relieving the pressure resolves the symptoms
2) If it does - insert a ventriculoperitoneal shunt
Side effects of carbamazepine?
CARBA MEAN
Confusion
Ataxia
Rashes
Blurred vision
Aplasic anaemia
Marrow (bone marrow) suppression
Eosinophilia
ADH release
Neutropenia
What antidepressant should be avoided in patients also taken an anticoagulant (e.g. warfarin)?
SSRIs - increase risk of bleeding
Differentiating thought blocking from thought withdrawal?
In thought blocking - when patient starts talking again, they will talk about an entirely different topic.
What is a delusion of guilt?
Also referred to as delusions of sin or worthlessness, this delusion is characterised by the belief that one deserves to be punished.
Usually, the ‘sin’ is an innocent error out of proportion to the guilt felt.
What condition are delusions of guilt often associated with?
Severe depression
CT findings in normal pressure hydrocephlaus?
Enlarged ventricles and absent sulci
The sulci are absent as they are compressed by the ventricles which allows for the pressure to be normal despite the CSF increase.
Why is pressure normal in normal pressure hydrocephlaus?
The sulci are compressed by the ventricles - allows for pressure to be normal.
Define a delusional perception
A delusion that is formed in response to an external stimulus without any logical sense.
CSF findings in autoimmune encephalitis?
Antibodies against NMDA receptors.
Features of autoimmune encephalitis?
- confusion
- seizures
- movement disorders
- behavioural changes
- emotional lability
- psychosis
- congitive impairment
- reduced conscious level
Mx of autoimmune encephalitis?
IV methylprednisolone & IV immunoglobulins
What part of the brain is responsbile for the fight or flight response?
Amygdala
The left amygdala appears to be larger in individuals diagnosed with anxiety disorders.
What area of the brain appears to be enlarged in individuals with anxiety disorders?
Left amygdala
Give 3 examples of LOW-intensity psychosocial interventions in the mx of depression
1) Individual guided self-help (based on principles of CBT)
2) Computerised CBT
3) Structured group physical activity programme
What are 3 examples of HIGH intensity psychological therapies in depression?
1) CBT
2) Interpersonal therapy (IPT)
3) Behavioural activation
What is behavioural activation?
Getting people to act according to a plan rather than based on how they feel.
E.g. going on a walk every day
Depression is associated with a decrease in which neurotransmitters in the brain? (2)
1) Serotonin
2) Noradrenaline
How long do patients need to stay on SSRIs for if they have had 2 or more periods of depression?
At least 2 years
What is the target range of lithium for relapse prevention?
0.60-0.8 mmol/L
