Memory clinic stuff

Question 1

What is asked in history at mem clinic?

Answer 1

• timeline from collateral
• degree of insight
• cognitive assessment: attention and orientation, memory, language, executive function, apraxia, visuospacial abilitym (8 As)
• assesment of behavioural symtoms: aggression, agitation, restless, pychosis, sexual disinhibiton, wandering
• ability to drive
• mood
• degree of support
• risks: wandering, cooking, neglect
• comorbidities
• ADLs: self care, managing finances, driving, social network

Question 2

What investigations are carried out at mem clinic

Answer 2

• physical exam: cause of infection or focal neurology
• bloods: U+E, fbc, haematinics, TFT
• ECG
• CXR
• ? EEG
• MSU
• ?LP
• CT/ MRI almost always to exclude differentials
• extended cognitive assessment eg ACE or MOCA

Question 3

What are the 8 As?

Answer 3

• Anosognosia: dont realise something is wrong
• Amnesia: memory loss
• Agnosia: dont recognise sense eg sight/ smell
• Aphasia: loss of language
• Apraxia: loss of purposeful movement and direction following
• Apathy
• Altered perception: illusions and delusions
• attention deficit

Question 4

What drugs are effective in alzheimers?

Answer 4

• donepezil, rivastigmine and galantamine (ACHe inhibitors)- do not impact cognition but may help behavioural symptoms
• memantine (NMDA receptor antagonist)- however can cause seizures
• these are of little- no use in vascular or frontotemporal demenita

Question 5

What 10 questions are asked for abbreviated mental test?

Answer 5

age, time, year, location, identify 2 people, DoB, historic date, current world leader, count down from 10, recall an address