Memory Loss Flashcards
What is Dementia?
Cognitive impairment which is progressive, multi domain affects life and due to brain disease occurring in over 40s
cognitive domains?
memory
language
visuospatial
executive
social behavioural
psychiatric
Alzheimer’s disease features?
beta amyloid aggregation
then tau aggregration (neurofibrillary tangles)
loss of function, loss of cells
amyloid angiopathy
what is TDP-43?
DNA binding protein
FTLD and prion cause
rapid brain shrinkage
visuospatial alone?
posterior cortical atrophy
FTLD often includes?
tau TDP43 FUS
parkinsons disease includes which protein?
alpha synuclein
fixed cognitive impairment?
ADHD, ASD, learning disability, perinatal hypoxia, meningitis, head injury, stroke
vascular dementia?
slowness and efficiency of thought, not memory or language
slowable causes of cognitive impairment?
hydrocephalus normal pressure
b12 deficiency
cerebrovascular damage
alcohol damage
which ion causes cognitive impairment?
hyponatraemia
mild cognitive impairment?
only one domain typically memory
or doesnt affect daily life
Benefits of MRI?
no radiation
better imaging: grey matter - cortical thickness, atrophy
white matter- vascular lesions
fazekas scale looks at?
white matter change, vessel disease
diagnosis of alzheimers?
markers of amyloid deposition and neurodegenerative changes
what does FDG-PET look at in Alzheimers?
hypometabolism- temporoparietal usually drop out more
frontal lobe damage can cause?
disinhibition
semantic memory loss?
know what things are and facts , temporal lobe left
Lewy body dementia features?
parkinsonian features, hallucinations
what imaging can you do for lewy body dementia?
dopaminergic SPECT, due to reduced dopamine uptake
how to image Tau?
PET radiolabel tau with braak staging
scanning for Alzheimers?
neuroinflammatory scanning
high resolution MRI- subfield-level
diffusion tensor imaging and tractogrpahy- meaure white matter tract
cognitive reserve?
adaptability of cognitive processes underpinning differential susceptibility to brain aging or disease
brain reserve?
neurons and synapses
risk factor for Alzheimers?
apoE e4 allele
what is associated with slower cognitive decline
higher brain BDNF gene expression
what increases the anticoagulant effect of warfarin and by which mechanism?
metronidazole, CYP450 inhibition
what would reduce exposure to theophylline and mechanism?
rifampicin, inducer of cytochrome P450
which are the cytochrome p450 inhibitors?
amiodarone
ciprofloxacin
erythromycin
clarithromycin
metronidazole
fluconazole
isoniazid
alcohol
grapefruit juice
cytochrome p450 inducers?
increase drug metabolism and reduce exposure
CRAP
carbamazepine
rifampicin
alcohol chronic
phenytoin
colchicine side effect?
b
etoricoxib is a?
cox 2 inhibitor
advantage of cox 2 inhibitor?
selective, so less likely to cause gastric side effects
NSAIDs cause?
increase sodium reabsorption and hence water too
cox 2 inhibitors have a risk of?
clotting
amiodarone causes?
inhibits efflux of digoxin by p glycoprotein pump and therefore reduced its clearance
common side effects of amiodarone?
thyroid- hypo/hyper
grey skin- shield from light, photosensitivity
sleep disorders
hepatic
corneal deposits/ optic neuropathy, blurred vision
pulmonary toxicity
loading dose for amiodarone?
high half life and strongly protein bound (albumin) so give lots to block of all proteins
how many half lives to achieve a steady state?
5
for sepsis gentamicin is given?
1 daily, infective endocarditis 2 daily
why is weight important for gentamicin?
water soluble drug, always dose on a lean body weight
significant drug interaction with gentamicin?
bumetanide- loop diuretic
ototoxic side effects
increases risk of nephrotoxicity
scoring system for stroke risk?
CHA2DSVAS
how does apixaban work?
factor 10 inhibitor
in AKI metformin needs to be stopped because of?
acidosis
