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old age psych Flashcards

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1
Q

DSM V dementia criteria?

A
  1. multiple cog defects
  2. memory impairment
  3. at least one of : aphasia, apraxia, agnosia, executive fxn prob
  4. impaired social or occupational function
  5. decline from a previously better level of fxn
  6. can’t attribute to anything else and are not just delirium
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2
Q

most common dementia?

A

alzheimers

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3
Q

proven RFs for alzheimer’s dementia?

A
  1. age
  2. DS
  3. apolipoprotein e4 allele
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4
Q

likely RFs for alzheimer’s dementia?

A
  1. females
  2. head injury
  3. post menopause
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5
Q

possible RFs for alzheimer’s dementia?

A

fhx parkinsons, vascular, DS

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6
Q

proven protective factors alzheimers?

A

apolipoprotein e2 allele

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7
Q

possible protective factors AD?

A
  1. smoking
  2. NSAIDs
  3. oestrogen
  4. premorbid personality + education
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8
Q

genes associated with early onset AD?

A

presenilin

beta amyloid precursor

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9
Q

1st degree relative risk of AD?

A

15-19%

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10
Q

neuropathology of AD?

A
  1. diffuse atrophy
  2. flat sulci
  3. enlarged ventricles
  4. plaques, NF tangles, neuronal loss, synaptic loss,
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11
Q

where else do you see plaques>

A

Down’s syndrome

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12
Q

Neuroimaging in AD?

A
  1. CT - cortical atrophy (parietal and temporal) + 3rd ventricle dilation
  2. MRI - less grey matter, and reduced volume in hippocampus, amygdala and temporal lobes
  3. PET - reduced blood flow and metabolism in parietal and temporal
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13
Q

what is lexical anomia?

A

seen in AD

problem finding the words

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14
Q

what is apraxia?

A

prob with learned motor tasks

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15
Q

what is agnosia?

A

can’t recognise peripheral sensory stimulation and parts of body

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16
Q

behavioural features of AD?

A
  1. wandering
  2. aggression
  3. sexual disinhibition
  4. incontinence
  5. searching
  6. eating
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17
Q

psych features of AD?

A
  1. delusions
  2. auditory and visual hallucinations
  3. depression
  4. psychotic = rapid decline - survival 8yrs
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18
Q

signs of progression in AD?

A

increasing agitation
emotional outbursts
night pacing, poor sleep, wandering

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19
Q

terminal phase AD?

A

profound disorientation
double incontinent
amnestic

20
Q

what are the anti AD drugs?

A
  1. donezepil, rivastigmine, galantamine - cholinesterase inhibs
  2. memantine - NMDA agonist - protects neurons from glutamate - may augment donezepil
21
Q

_______ is useful in parkinsons dementia

A

rivastigmine

22
Q

______ is used in vasc and mixed dementia.

A

memantine

23
Q

_____ is hepatotoxic

A

tacrine

24
Q

ginkgo biloba is ______

A

useless

25
Q

poor px factors in AD

A
  1. male

2. onset

26
Q

what are some cognitive tests

A 
MMSE
CAPE
AMTS
CAMCOG
Clock drawing
27
Q

cut off in MMSE is ___

A

24/30

28
Q

MMSE screens for _____

A 
cog dysfunction
orientation
memory
concentration
language
praxis
gnosis
29
Q

MMSE varies due to _______

A

age
SE
education
verbal performance

30
Q

cutoff in AMTS is ______

A

7-8/10

31
Q

AMTS covers ______

A

memory

orientation

32
Q

clock drawing tests _____

A

praxis

33
Q

types of vascular dementia?

A
  1. post stroke deficits
  2. multi-infarct dementia
  3. progressive small vessel disease (binswangers)
34
Q

key features of vascular dementia?

A
  1. uneven cognitive impairment
  2. abrupt onset, stepwise deterioration
  3. focal signs
  4. can coexist with alzheimers
35
Q

key features multi infarct dementia?

A
  1. gradual onset

2. minor ischaemic episode hx

36
Q

key features subcortical dementia?

A
  1. hx of HTN
  2. deep white matter ischaemia
  3. well preserved white cortex
37
Q

insight in vascular dementia is ______

A

retained

38
Q

somatic complaints in vascular dementia are _______

A

common eg headache and dizzy

39
Q

what is lewy body dementia?

A
  1. progressive w/ parkinsonism
  2. fluctuating cognition with profound variations in alertness and attention
  3. detailed visual hallucinations
  4. parkinsonism
  5. falls, faints, loss of consciousness
  6. delusions
  7. spared short term memory and medial temporal lobes
40
Q

histology of LBD?

A

eosinophilic intracytoplasmic inclusions

41
Q

define parkinsons dementia?

A

where parkinsons sx >12 months before the dmenentia

42
Q

define frontotemporal dementia?

A
  1. slow onset
  2. frontal lobe
  3. emotioanlly blunt
  4. disinhibited
  5. apathy
  6. restless
  7. aphasia
  8. personality change
43
Q

onset of FTD is _____

A

45-65

44
Q

dementia in CJD is _____

A 
fast
myoclonus
cerebellar and EPS signs
visual probs
death in 1yr
45
Q

on EEG in dementia of CJD?

A

periodic complexes

46
Q

what is pseudodementia?

A
  1. cognitive impairment seen in psych disorders - mostly depression
47
Q

what are the caine criteria for pseudodementia?

A
  1. ID in pt with 1y psych prob
  2. similar to features of impairment in CNS disorders
  3. reversible deficits
  4. no neurological condition

Psych (23 decks)

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