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MBBS VI - SpC - Psychiatry > Geriatrics - Psychogeriatric > Flashcards

Geriatrics - Psychogeriatric Flashcards

1
Q

Dementia

Spectrum of dementia

A

Dementia: syndrome that may be caused by a number of different brain disorders involving mental decline severe enough to disrupt daily life that affects more than one core brain functions: Recent memory, Language, Visuospatial function, Executive function.

Major Neurocognitive Disorder: Significant cognitive decline + interfere with B-ADL and I-ADL

Mild Neurocognitive Disorder: Modest cognitive decline + does not interfere B-ADL nor I-ADL. 10-15% of Mild NCD progress into Major NCD every year

Mild Cognitive Impairment: minor problems with cognition, NOT severe enough to interfere significantly with daily life (B-ADL, I-ADL), and so are not defined as dementia. 6-25% Annual rate of progression to Dementia (compared to normal individual 1-2%)

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2
Q

Dementia

Prevalence with age
Distribution of most common causes

A
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3
Q

Mnemonic for dementia

A
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4
Q

Primary neurological diseases/ dementia syndromes

A
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5
Q

Secondary causes of dementia

A
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6
Q

Congenital causes of dementia

A
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7
Q

Risk factors of dementia
Protective factors against dementia

A
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8
Q

*

Domains of cognitive impairment

A

PCELLS

Perceptual motor
Cognition
Executive function
Language
Learning and memory
Social cognition

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9
Q

Complex attention

Signs of impairment

A
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10
Q

Executive ability

Signs of impairment

A
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11
Q

Learning and memory

Signs of impairment

A
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12
Q

Language

Signs of impairment

A
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13
Q

Perceptual motor

Signs of impairment

A
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14
Q

Social cognition

Signs of impairment

A
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15
Q

Behavioural psychological symptoms of Dementia

A
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16
Q

Diagnostic criteria of dementia

A

+ Caregiver stress, Institutionalisation

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17
Q

Clinical assessment of dementia

A

ADL: B-ADL and I-ADL

Behavioural psychological symptoms of Dementia
- Anxiety, Apathy, Aggression, Agitation, Irritability, Verbal outbursts
- Delusion, Hallucination
- Motor behavior abnormality, night time behavioural disturbance

Cognition: 6 domains
- AMT, MMSE, MoCA, Clock drawing test

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18
Q

Dementia

Ix

A
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19
Q

Alzheimer’s disease

Brain region affected

A
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20
Q

Frontotemporal dementia

Brain region affected

A
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21
Q

Primary Progressive Aphasia

Brain region affected

A

Pericentral sulcus

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22
Q

Corticobasal degeneration

Brain region affected

A

Corpus Callosum, Perisylvian fissure

23
Q

Progressive Supranuclear Palsy

Brain region affected

24
Q

Multisystem atrophy

Brain regions affected

25
Q

Lewy body dementia

Brain regions affected

26
Q

Vascular dementia

Brain regions affected

27
Q

Normal pressure hydrocephalus

Brain region affected

28
Q

Advanced neuroimaging techniques for dementia

29
Q

Dementia management

A

Heart block, Asthma, Acute angle closure glaucoma C/I vs AchEi
S/E: Rhabdomyoltsis, NMS, Bradycardia, Anorexia, GI S/E

30
Q

Prevention of dementia

31
Q

Alzheimer’s disease

Prevalence
Prognosis

32
Q

Alzheimer’s disease

Risk factors

33
Q

Alzheimer’s disease

Pathogenesis

A

Clinical manifestation- Atrophy in AD usu. starts from Temporal lobe, then to Hippocampus → Memory deficit- **Cholinergic deficit **

  • Loss of cholinergic biosynthetic machinery
  • Loss of basal forebrain cholinergic neurons (that projects to Hippocampus)
  • Cholinergic deficit also contributes to memory and attention impairment
34
Q

Clinical course of Alzheimer’s disease

A

Early Alzheimer signs: Amnesia, Spatial disorientation, Circumlocution

Advanced Alzheimer: Sloppily dressed, Slow, Apathetic, Confused, Disoriented, Stooped posture

Terminal Alzheimer: Bedridden, Stiff, Unresponsive, Nearly mute, Incontinence

35
Q

Neuropsychiatric features of Alzheimer’s disease

36
Q

Alzheimer’s disease

Diagnostic criteria

37
Q

Alzheimer’s disease

Investigations

38
Q

Alzheimer’s disease

Management plan

39
Q

Alzheimer’s disease

AChEI and NMDA-R MoA, ADR

40
Q

Vascular dementia

Spectrum

41
Q

Vascular dementia

Causes

42
Q

Vascular dementia

Risk factors

43
Q

Vascular dementia

Clinical presentation

A

Stepwise deterioration of cognitive ability
- Lose executive function first
- Sparing episodic memory, recall, verbal learning
- Cortical signs + narrow based gait
BPSD of VD:
- Apathy, pseudo-bulbar effect, depression

44
Q

Vascular dementia

Diagnostic criteria

45
Q

Vascular dementia

Management

46
Q

Lwey body dementia

Disease spectrum

47
Q

DLB

Clinical features

A

Core:
Visual hallucination
Cognitive fluctuations: Staring, disorganized speech, drowsiness
Parkinsonism
REM sleep behaviour disorder: Dream enactment

BPSD of LBD: Apathy, Anxiety, Depression

48
Q

DLB

Diagnosis

49
Q

DLB

Management

50
Q

Types of Parkinsonian syndromes with dementia

51
Q

Normal pressure hydrocephalus

Risk factors

52
Q

NPH

Clinical presentation

53
Q

NPH

Diagnosis

54
Q

NPH

Management

MBBS VI - SpC - Psychiatry (22 decks)

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