Memory issues

Question 1

Examinations for memory (4)

Answer 1

• AMTS (abbreviated mental test score)
• MOCA test
• MMSE (Mini Mental State Exam)
• Collateral history

Question 2

Blood tests for memory issues (7)

Answer 2

• Urinalysis
• FBC
• U+E/LFT/calcium
• B12/folate/TSH
• Cholesterol
• HbA1c
• HIV/Syphillus

Question 3

What are investigations are done in dementia to rule out?

Answer 3

Delrium

Question 4

Alzhiemer’s dementia (6)

Answer 4

• Over 60
• Slow progress over time
• Memory loss
• Planning
• Reasoning
• Speech
• Recognition

Question 5

Vascular dementia (5)

Answer 5

• Single infarct = acute cognitive impairment
• Functional deficit before memory impairment
• Mood disturbance/disorder
• Delusion/hallucination/psychosis in later stages
• Paranoia
• Depression
• Psychomotor retardation
• Stepwise progression : stability at 1 functional level, acute decline progression, another stability period

Question 6

Vascular dementia progression (3)

Answer 6

STEPWISE

• Stability period 1 level of functioning
• Acute decline progression
• Stability period at new level of functioning

Question 7

Lewy-Body Dementia (6)

Answer 7

• Visual hallucination
• Parkinson-like symptoms
• Physical before cognitive by more than 1 year =
• Multitasking + complex cognitive actions before memory issues
• Sleep disorders
• Rapidly progressive = death in 7 years

Question 8

When is Lewy-Body Dementia diagnosed as Parkinson’s instead?

Answer 8

More than 1 year = physical symptoms before cognitive decline
= Parkinsons superimposed cognitive decline

Question 9

Lewy-Body Dementia progression (2)

Answer 9

• Rapidly progressive

- Death in 7 years post-diagnosis

Question 10

Frontotemporal dementia key clinical features (4)

Answer 10

• Personality + behaviour changes (psychiatry)
• Progressive language difficulty
• Aphasia
• Average life expectancy post diagnosis = 8 years

Question 11

Frontotemporal dementia progression

Answer 11

Average life expectancy post diagnosis = 8 years

Question 12

3 types of frontotemporal dementia presentation (3)

Answer 12

• Behavioural
• Semantic
• Non-fluent

Question 13

Behavioural presentation of frontotemporal dementia (5)

Answer 13

• Altered emotional responsiveness
• Apathy
• Disinhibition
• Impulsivity
• Food preference + childlike amusement changes

Question 14

Semantic presentation

Answer 14

• Progressive decline in word meaning understanding