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PSYCHIATRY > Memory problems > Flashcards

Memory problems Flashcards

1
Q

What is anterograde amnesia?

What is retrograde amnesia?

A

Anterograde amnesia; difficulty in remembering new information since the onset of the illness

Retrograde amnesia; difficulty in remembering past information from prior to the onset of the illness

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2
Q

List some of the reversible causes of memory loss

A

Depressive pseudodementia

Wernicke-Korsakoff syndrome

Normal pressure hydrocephalus

Delirium

PTSD

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3
Q

When would you do MoCA and when would you do an Addenbrookes?

A

MoCA is quicker so done by a GP or if the patient is too anxious or unable to complete a longer test

Addenbrookes is the test commonly done in old age psychiatry

*Both look at memory and cognitive function

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4
Q

What is dementia?

A

Progressive global cognitive decline which is irreversible

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5
Q

What are the 4 primary dementias?

A

Alzheimer’s

Lewy body dementia

FTD

Huntington’s disease

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6
Q

What are examples of secondary dementias?

A

Vascular dementia

Infection

Trauma

Metabolic

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7
Q

What are some of the risk factors for dementia?

A

Age
Alcohol
Diet
Concussions

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8
Q

What cognitive tests can be done to assess a patient with dementia?

A

MMSE
MoCA
Addenbrooke’s

Frontal assessment battery (FAB)

Neuropsychological testing

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9
Q

Why should bloods be part of the routine investigation for dementia?

A

To rule out other causes of the presentation such as; syphilis, thyroid problems and vitamin deficiencies

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10
Q

What is the best imaging investigation to do in a patient with suspected dementia?

A

CT

Less distressing for a patient than MRI an cheaper

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11
Q

When should an MRI be done in a patient presenting with memory problems?

A

Young patients, atypical presentation, unclear diagnoses

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12
Q

What medications can be used in the management of Alzheimer’s disease?

A

Acetylcholinesterase inhibitors

Memantine

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13
Q

What are the contraindications to the use of acetylcholinesterase inhibitors in patients with alzheimer’s disease?

A

Asthma and COPD

Causes bradycardia - so must check pulse

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14
Q

When should a patient be started on memantine?

A

In moderate cases of Alzheimer’s or when acetylcholinesterase inhibitors are contraindicated or have not worked for the patient

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15
Q

What is mild cognitive impairment?

A

Noticeable cognitive impairment with little deterioration in function

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16
Q

What is the most common form of dementia in the elderly?

A

Alzheimer’s

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17
Q

What condition is associated with an increased risk of developing Alzheimer’s later in life?

A

Down’s syndrome

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18
Q

Which is affected first in patients with alzheimer’s; memory or behaviour?

A

Memory first, behaviour later

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19
Q

Which type of memory is affected first in patients with Alzheimer’s?

A

Short - term

atrophy of the hippocampus

20
Q

What is agnosia, a symptom of Alzheimer’s?

A

Difficulty in recognising familiar faces and objects

21
Q

What is anosognosia, a feature of Alzheimer’s disease?

A

Lack of insight

22
Q

Visuo-spatial issues can occur in Alzheimer’s if what part of the brain is atrophied?

A

Posterior cortical

23
Q

What is capgras syndrome?

A

A type of delusion which occurs in Alzheimer’s

The patient has the irrational belief that someone they know or recognise has been replaced by an imposter

24
Q

What are fregoli delusions?

A

A type of delusion which occurs in Alzheimer’s

Irrational belief that multiple people are in fact the same person who changes appearance or is in disguise

25
Q

What causes Alzheimer’s?

A

Accumulation of the degradation products of the amyloid precursor protein

26
Q

Describe the macroscopic pathology in Alzheimer’s disease

A

Widening of sulci and narrowing of gyri

Compensatory dilatation of the ventricles

27
Q

What are some of the microscopic features of Alzheimer’s dementia?

A

Neuronal loss with associated astrocyte proliferation

Neuritic plaques

Amyloid angiopathy

Neurofibrillary tangles

28
Q

What is the 2nd most common cause of dementia?

A

Vascular dementia (multi-infarct dementia)

29
Q

Which is affected first in vascular dementia; behaviour or memory?

A

Behaviour is affected first, memory is affected later

30
Q

Describe the progress of vascular dementia

A

Sudden onset with stepwise progression

31
Q

What would you be likely to see on CT/MRI in a patient with vascular dementia?

A

Multiple lacunar infarcts

32
Q

What is the 3rd most common form of dementia?

A

Lewy Body Dementia

33
Q

Which type of dementia is one of the Parkinson + syndromes?

A

Lewy Body Dementia

34
Q

Describe the progress of Lewy Body dementia

A

Fluctuating levels of attention and cognition on a day-to-day basis

35
Q

Lewy Body dementia can be similar in its presentation to delirium. What things could you ask about to differentiate the two?

A

Parkinsonism symptoms

History of falls

36
Q

What are some of the clinical signs and symptoms of Lewy Body Dementia?

A

Visual hallucinations

REM sleep disorders

Parkinsonism and falls

Dementia

37
Q

What drug should not be given to patients with Lewy Body dementia?

A

Haloperidol

38
Q

How can Parkinson’s dementia be differentiated from Lewy Body dementia?

A

Lewy body dementia; parkinsonism and dementia occur at roughly the same, or if parkinsonism appears first, symptoms must have been present for <1 year before the onset of dementia

Parkinson’s dementia; parkinson’s first, dementia years later

39
Q

What is the function of the frontal lobe of the brain?

What is the function of the temporal lobe of the brain?

A

Frontal; Structured thinking and behaviour

Temporal; Making memories

40
Q

Describe the progression in FTD

A

Rapid progression

41
Q

What part of the brain is the first to be affected in patients with FTD?

A

Frontal lobe
(behaviour first)

These patients can often therefore perform well on cognitive testing

42
Q

What 3 syndromes can occur in FTD?

A

Behavioural

Semantic

Primary progressive aphasia

43
Q

Describe behavioural FTD

A

Personality and behaviour changes, disinhibition, impulsivity, changes in eating habits and loss of social skills

44
Q

Describe semantic FTD

A

Speech and communication problems

Patient may become mute with time

45
Q

Describe primary progressive aphasia FTD

A

Effortful non-fluent speech with articulation errors

46
Q

What are the triad of symptoms in Huntington’s disease?

A

Triad of emotional, cognitive and motor disturbance

47
Q

Where are the most common areas of missed pain and distress in patients with dementia?

A

Teeth, back and feet

PSYCHIATRY (11 decks)

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