OPH Flashcards

1
Q

Early onset alzheimer’s disease - 5% of all AD, genes

A

Amyloid precursor protein, presenilin 1&2

Autosomal dominant with almost complete penetrance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Frontotemporal dementia genes

A

Autosomal dominant variable pentrance
40% affected 1st degree relative

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Late onset alzheimers genetics

A

Apo E contributes vascular

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Dementia lifetime risk

A

20% women
10% men

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Clinical diagnosis of dementia

A

Mostly history from patient and relatives

FHx, PMH, Drug history
HPc

How did it start?
* When did it start?
* How has it progressed?
* What can they NOT do now that they could do before?
* What do they DO now that you wish they didn’t do?
* What are they still doing that you think they shouldn’t
be doing?
* Visual hallucination ,delusions, failure to recognise
family members

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Dementia investigations

A

tests for remediable causes - FBC, Us&Es, B12, Folate, TSH, CXR

Imaging - CT, MRi - early in course of dementia often completely normal, check for alt diagnosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Dementia risk factors

A

Age, FHx, HTN, Cholesterol, DM, Smoking, mid-life obesity, alcohol, head injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Lewy body dementia characteristics

A

Prominent visual hallucinations, visuospatial problems, fluctuating course, 70% neuroleptic sensitivity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Frontotemporal dementia characteristics

A

Personality & behaviour change, language problems, younger age groups

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Alzheimer’s meds

A

Cholinesterase inhibitors - donepezil or rivastigmine may help some people with symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Dementia management

A

Social support, driving, EPOA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Frontotemporal dementia cell changes

A

Pick Bodies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Alzheimers cell changes

A

Tau tangle and amyloid plaques in hippocampus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Lewy body dementia

A

Lewy bodies in substancia nigra (basal ganglia)

Cortex, brainstem, limbic system

Parkinson’s associated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Delirium if a patient is on a benzo it is better to keep it going than to stop it

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Delirium worse in

A

Evening, overnight

17
Q

Common causes of delirium

A

Medical illnesses, drugs & their withdrawal esp benzos and alcohol, environmental changes, emotional stress, post-op

18
Q

Delirium management

A

Prevention / treat underlying cause, patient watch, may need sedation, haloperidol

19
Q

Parkinson’s disease dementia develops in

A

at least 30%

depression in 50%

Urinary frequency, urgency, incontinence, constipation, more delirium, swallowing issues, mobility, sleep

20
Q

SMART goals in rehab

A

Specific
Measurable
Achievable
Relevant
Time-bound

21
Q

NASC supports offered

A

Home help, personal care assistance, nutritional supports, care support/respite care, residential care placements

22
Q

Home help eligibility

A

If have community service card

No if
- no community service card
- live with able bodied person

23
Q

Home help includes

A

Vacuuming, cleaning bathroom, meal preparation

Not washing dishes, spring cleaning, dusting

24
Q

Fluid cognition

A

Innate ability to learn new information and problem solve - reduces from 3rd decade

25
MCI reversible
Sometimes - if depression, meds etc
26
How many alzheimer's
1/9
27
Don't give donepezil or rivastimine in
Bradycardia, long QT
28
Vascular dementia
Post-stroke
29
Lewy body if need antipsychotic
Only quetiapine - try to avoid antipsychotics Cholinesterase inhibitor, L-dopa may help
30
Rapid progressive dementia
Creutzfeldt jacon
31
4AT
Alertness. AMT4, attention (months backward), altered behaviour/cognition
32
Sarcopenia
Idenitfied by no.1, confirmed by no. 2, all 3 met then severe 1) low muscle strength 2) low muscle quality or quantitity 3) low physical performance
33
Cachexia
Metabolic syndrome secondary to underlying illness - loss of muscle +/- fat, catabolic>anabolic
34
Malnutrition criteria
At least 2 of Weight loss, muscle loss, SC fat loss, insufficient energy intake, muscle strength loss, fluid acumulation
35
Frailty criterie (fried)
3/5 Low grip strength, unintentional weight loss, low physical activity, slow walking speed
36