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FINALS - NEURO > MFE - acute presentations // dementia > Flashcards

MFE - acute presentations // dementia Flashcards

1
Q

what can predispose acute confusion

A

infection // metabolic // environment change // constipation // pain // dementia

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2
Q

symptoms delirium

A

short term amnesia // agitated // mood change // hallucinations // disturbed sleep // impaired consciousness

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3
Q

1st line mx sedative delirium

A

haloperidol or olanzapine

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4
Q

sedation mx in patients with parkinsons

A

atypical antipsychotic eg quetiapine or clozapine

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5
Q

mx causing postural hypotension

A

nitrates // diuretics // anticholingeric meds // antidepressants // BB // L-dope // ACEi

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6
Q

what special tests can be done OE to asses fall risks in elderly

A

turn 180 // times up and go

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7
Q

what is multimorbidity

A

2 or more long term conditions (can be psych, substance, learning disability, physical)

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8
Q

what questionnaire can assess frailty

A

PRISMA-7

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9
Q

what is STOPP/ START med review

A

stop risk meds + start good ones

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10
Q

RF for pressure falls in elderly

A

malnourishment, incontinence, mobility, pain

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11
Q

where do pressure ulcers usually occur

A

sacrum or heel

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12
Q

questionnaire for pressure ulcers

A

waterloo score - BMI, nutrition, skin type, mobility, incontinence

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13
Q

mx pressure uclers

A

moist hydrocolloid dressing // surgical debridement if necessary

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14
Q

assessment tools for dementia

A

10-CS, 6ITs, adams brooke, 4 AT

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15
Q

what invx for dementia is recommended

A

blood screen –> neuroimaging

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16
Q

top 3 causes of dementia

A

Alzheimers –> cerebrovascular –> lewy body

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17
Q

less common causes of dementia

A

Huntingtons, CJD, Pick’s, HIV

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18
Q

RF Alzheimer’s

A

age // FH // genetics + white // Down syndrome

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19
Q

genes that can predispose Alzheimer’s

A

presenilin 1 + 2 // apoprotein E4

20
Q

macroscopic changes Alzheimer’s

A

cerebral atrophy esp in cortex and hippocampus and meynerts nucleus

21
Q

microscopic changes Alzheimer’s

A

tau protein –> neurofibrilliary tanges // beta-amyloid deposits

22
Q

1st line medical mx Alzheimer’s

A

AChE inhibitors eg donepezil, galantamine, rivastigmine

23
Q

2nd line medical mx

A

memantine (NDMA antagonist)

24
Q

when would 2nd line medical mx Alzheimer’s be used

A

intolerant to AChE inhib // dual therapy // monotherapy in severe disease

25
Q

mx for symptoms of depression in patients

A

antipsychotics (not anti-depressants)

26
Q

when is donepezil contraindicated

A

bradycardia (+ it causes insomnia)

27
Q

3 main subtypes of vascular dementia

A

stroke related // subcortical (small vessel) // mixed dementia

28
Q

RF vascular demention

A

PMH stroke or TIA // AF // HTN // DM // smoking // obesity// CVD

29
Q

presentation pattern Vascular dementia

A

months or year stepwise deterioration

30
Q

symptoms vascular dementia

A

focal neuro // attention // seizure // memory // gait // speech // emotional

31
Q

which criteria is used for vascular dementia

A

NINDS-AIREN

32
Q

imaging in vascular dementia

A

MRI (or SPECT)

33
Q

mx vascular dementia

A

not much - only AChEi in paitients with AD

34
Q

symptoms lewy body dementia

A

early cognitive impairment (attention and execute function and memory loss) // Parkinsonism (AFTER cognitive symptoms // hallucinations

35
Q

how does lewy body dementia present differently to AD in early stages

A

AD mainly memory // lewy body has other impairments such as attention and function

36
Q

imaging lewy body

A

SPECT

37
Q

mx lewy body

A

AChEi (donezepil, rivastigmine) + memantine

38
Q

what drugs should be avoided in lewy body dementia

A

antipsychotics (they will deteriorate a patient)

39
Q

pathology lewy body dementia

A

Lewy bodies (alpha inclusions) in substantia nigra

40
Q

3 types of frontotemporal lobar degeneration

A

frontotemporal dementia (picks) // progresive non fluent aphasia // semantic dementia

41
Q

features frontotemporal dementias

A

early onset (<65) // insidious onset // preserved memory in early disease // personality + inappropriate changes

42
Q

pathophysiology Pick’s disease

A

atrophy of frontal and temporal lobes // Pick bodies // gliosis // neurofibrillary tangles // senile plaques

43
Q

what causes creutz-feldt jacob disease

A

prion proteins –> beta sheats

44
Q

symptoms creutz-feldt jacob disease

A

rapid onset dementia + myoclonus + slurred speech

45
Q

invx creutz-feldt jacob disease

A

CSF: raised 14-3-3 proteins // EEG // MRI

46
Q

early –> late symptoms AD

A

early = misplaced keys, fogotten appointments // late = personality changes, cognitive changes

FINALS - NEURO (16 decks)

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