Organic disorders

Question 1

F00

Answer 1

-ICD 10 for organic disorders such as dementia

Question 2

Depressive pseudodementia

Answer 2

• not a diagnostic category but descriptive term
• onset can be dated and rapid progression
• patients actively complain of memory impairment
• nocturnal accentuation is uncommon
• attention and concentration are well preserved
• answer ‘dont know’ to questions on cognitive testing
• memory loss for remote events may be more severe than recent ones

Question 3

Dementia in ALzheimers disease

Answer 3

• global decline in intellectualy capacity and disturbance of higher cortical functions like memory, thinking, orientation, comprehension, calculation, language and learning, interference with ADLs
• insidious onset
• absence of evidence of organic brain disease
• absence of sudden onset or physical/neurological signs
• amnesia, aphasia, agnosia, apraxia,associated disturbance in behaviour

Question 4

Vascular dementia

Answer 4

• presence of dementia syndrome and muyst be severe enough to interfere with ADLS (not due to physical effects of a stroke)
• onset may be after CVA and is more acute
• course is stepwise with periods of stability
• focal neurological signs can be seen due to CVAs
• emotional and personality changes are typically early followed by cognitive deficits that are often fluctuating severity

Question 5

Dementia with Lewy Bodies

Answer 5

• spontaneous motor features of Parkinsonism
• fluctuating cognition with notable variation in attention and alertness
• recurrent visual hallucinations
• typically well formed and detailed
• cognitive decline is severe enough to interfere with normal social and occupational functioning
• sensitive to neuroleptics and falls

Question 6

Parkinsons disease dementia

Answer 6

• if Parkinsons symptoms have existed for 12 months before the dementia
• both motor symptoms and cognitive symptoms develop within 12 months then it is usually Lewy Body dementia

Question 7

Frontotemporal dementia

Answer 7

• insidious onset and gradual progression
• early loss of personal and social awareness
• early emotional blunting and loss of insight
• behavioural features- early signs of disinhibition, mental rigidity, poor grooming, perseverative behaviour, hyperorality
• speech disorder-reduced output and signs such as stereotypy, echolalia and perseveration
• affective symptoms
• physical signs- incontinece, akinesia, rigidity, primitive reflexes

Question 8

Delirium

Answer 8

• most cases recover in 4 weeks
• chronic lung disease, sub acute bacterial endocarditis and carinoma delirium may last up to 6 months
• in organic hallucinosis insight might be present
• encephalitis and CO poisoning cause organic catatonia
• influenza can cause post-infective depression