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Psychiatry > Memory > Flashcards

Memory Flashcards

1
Q

What are the different types of memory?

A
  • sensory
  • short term memory
  • long term memory which includes the following
  • explicit memory (conscious) > declarative memory (facts, events) > episodic memory (events, experiences) > semantic memory (facts, concepts)
  • implicit memory (unconscious) > procedural memory (skills, tasks)
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2
Q

What are the four steps of memory processing?

A
  • attention
  • encoding
  • storage
  • retrieval
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3
Q

What is anterograde amnesia?

A

Difficulty in acquiring new material and remembering events since the onset of the illness of injury

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4
Q

What is retrograde amnesia?

A

Difficulty in remembering information prior to the onset of the illness or injury

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5
Q

What is assessed in cognitive screening?

A
  • memory
  • attention and concentration
  • executive functioning
  • visuo-spatial functioning
  • language
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6
Q

What is the 4AT?

A
  • rapid assessment test for delirium

- aimed at detecting moderate-severe cognitive impairment

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7
Q

What are the components of 4AT?

A
  • alertness (normal/ mild sleepiness / clearly abnormal)
  • AMT-4 (age, DOB, place, current year)
  • attention (months backwards)
  • acute or fluctuating course
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8
Q

Which test is useful in the diagnosis of dementia?

A

MMSE

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9
Q

What is the MMSE?

A
  • mini mental state examination
  • a screening test scored out of 30
  • orientation, memory, visuospatial and language
  • crude test
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10
Q

What is the MoCA?

A
  • montreal cognitive assessment
  • rapid screening instrument for mild cognitive dysfunction
  • assesses multiple cognitive domains
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11
Q

What are the components of the addenbrookes cognitive examination?

A
  • scored out of 100 with 5 domains;
  • orientation and attention
  • memory
  • fluency
  • language
  • visuospatial functioning
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12
Q

Describe the features of mild cognitive impairment

A
  • noticeable cognitive impairment with little deterioration of function
  • ACE-III usually 75-90, MoCA usually 24-26 but can vary
  • repeat cognitive testing yearly
  • may benefit from home based memory rehabilitation
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13
Q

Describe the subjective cognitive impairment

A
  • patient feels that they are cognitively impaired but cognitive testing and day to day function are normal
  • patients often have a relative or friend with dementia
  • vicious cycle of increasing anxiety about memory causing more memory lapses is common
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14
Q

Name possible presenting complaints of alzheimers disease

A
  • memory loss particularly short term
  • dysphasia
  • dyspraxia
  • agnosia
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15
Q

What can be seen on CT/MRI in alzheimers disease

A
  • can be normal
  • medial temporal lobe atrophy or temporoparietal atrophy
  • variants; frontal or posterior cortical atrophy
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16
Q

Name possible presenting complaints in vascular dementia

A
  • dysphasia, dyscalculia, frontal lobe symptoms and affective symptoms more common than in alzheimers
  • may have focal neurological signs
  • may have vascular risk factors
  • may have step wise decline
17
Q

Describe what can be seen on CT/MRI and SPECT scanning in vascular dementia

A
  • CT/MRI; moderate-severe small vessel disease or multiple lacunar infarcts
  • SPECT; patchy reduction in tracer uptake throughout brain
18
Q

Describe the 3 syndromes of frontotemporal dementia

A
  • behavioural variant; behavioural changes, executive dysfunction, disinhibition, impulsivity, loss of social skills, apathy, obsessions, change in diet
  • primary progressive aphasia; effortful non-fluent speech, speech sound / articulatory errors, lack of grammar, lack of words
  • semantic dementia; impaired understanding of meaning of words, fluent but empty speech, difficulty retrieving names
19
Q

Describe what can be seen on CT/MRI and SPECT scanning in frontotemporal dementia

A
  • CT/MRI; frontotemporal atrophy

- SPECT; frontotemporal reduction in tracer uptake

20
Q

Describe the criteria for dementia with lewy bodies

A
  • dementia; common early involvement of reduced attention, executive function and visuospatial skills
  • two of; visual hallucinations, fluctuating cognition (delirium like). REM sleep behaviour disorder, parkinsonism (not more than 1 year prior to onset of dementia), positive DAT scan
21
Q

Name examples of cholinesterase inhibitors used in alzheimers disease

A
  • donezepil
  • rivastigmine
  • galantamine
22
Q

Name side effects of cholinesterase inhibitors

A
  • GI (nausea and diarrhoea most common)
  • headache
  • muscle cramps
  • bradycardias
  • worsen COPD / asthma
23
Q

Describe the features of memantine and its use in dementia

A
  • low affinity voltage-dependent non-competitive antagonist of NMDA receptors
  • may preferentially inhibit excessive NMDA receptor activation associated with excitotoxicity and spare normal function
  • also a weak antagonist at other amine receptors

Psychiatry (13 decks)

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