Memory & Dementia

Question 1

How is the hippocampus involved in memory?

Answer 1

Locating memories in the right time,place & context

Question 2

How is the amygdala involved in memory?

Answer 2

Stores emotionally charged memories

Question 3

What is the role of the medial prefrontal cortex in memory?

Answer 3

Connected to the amygdala

Regulates emotional & fear responses

Question 4

What is Vitamin B1 also known as?

Answer 4

Thiamine

Question 5

What is Korsakoff’s amnesia?

Answer 5

Severe thiamine deficiency
Bilateral loss of mamillary bodies in the brain
Anterograde amnesia

Question 6

What is the neuropathology of Alzheimer’s?

Answer 6

Beta amyloidplaques

Tauprotein build up - NFtangles

Question 7

Which are is first affected in Alzheimers?

Answer 7

Nucleus basalis of Menert

Question 8

How does Alzheimer’s present?

Answer 8

Gradual memory loss
Disorientation
Nominal dysphasia

Question 9

How is mild-moderate Alzheimer’s treated?

Answer 9

Cholinesterase inhibitors (Donepizil, Rivastigmine)

Question 10

How is severe Alzheimer’s treated?

Answer 10

Memantine

Question 11

What is the neuropathology seen in vascular dementia?

Answer 11

Multiple mini infarcts
White matter pallor
Perivascular tissue loss & dilation of perivascular spaces

Question 12

How does vascular dementia present?

Answer 12

Sudden onset

Stepwise detrioration

Question 13

How is vascular dementia managed?

Answer 13

Anti-platelets
Lifestyle modification
If carotid stenosis is >70% - carotid endartectomy

Question 14

What is the neuropathology seen in Lewy Body dementia?

Answer 14

alpha-synuclein inclusion in SN, paralimbic & neocortical areas
Decrease dopamine uptake in basal ganglia seen in SPECT & PET scans

Question 15

What are the features of Lewy Body dementia?

Answer 15

Neuroleptic sensivity (irreversible parkinsonism) 
Fluctuating cognition 
Parkinsonism 
Visual hallucinations 
REM sleep behaviour disorder
Falls

Question 16

How is Lewy Body dementia treated?

Answer 16

Cholinesterase inhibitors +/- dopaminergics

Question 17

How is REM behaviour disorder in Lewy Body dementia treated?

Answer 17

Clonazepam or melatonin

Question 18

What neuropathology is seen in fronto-temporal dementia?

Answer 18

Picks bodies ( tau +ve spherical cytoplasmic neuronal inclusions)
Picks cells (ballooned neurons with dissolution of chromatin) 
Frontotemporal atrophy without Alzheimer histology

Question 19

Features of fronto-temporal dementia?

Answer 19

Personality change
Progressive loss of language fluency
Memory impairment

Question 20

How does delirium present?

Answer 20

Impaired consciousness
Disturbance of cognition 
Psychomotor disturbance
Disturbance of sleep-wake cycle
Emotionaldisturbance

Question 21

What isthe treatment for acute delirium?

Answer 21

Halooperidol then Lorazepam

Question 22

What percentage of stroke patients suffer post stroke depression?

Answer 22

Up to 1/3

Question 23

How does Wernicke’s encephalopathy present?

Answer 23

Ataxia
Confusion 
Meningism 
Nystagmus 
Headache 
Hallucinations

Question 24

What causes Wernicke’s encephalopathy?

Answer 24

Thiamine deficiency

Question 25

What is the main complication of Wernicke’s encephalopathy?

Answer 25

Korsakoff’s psychosis (dementia with severe impairment of new learning)

Question 26

What are the symptoms of delirium tremens?

Answer 26

Visual hallucinations 
Tremor 
Agitation 
Sweating 
Anxiety 
Convulsions

Question 27

How is delirium tremens treated?

Answer 27

Benzos