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Neurology Week 5 2018/19 > 1: Cognitive neurology > Flashcards

1: Cognitive neurology Flashcards

(54 cards)

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1
Q

What is cognition?

A

Mental action of acquiring and understanding knowledge

Using thought, experience and senses

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2
Q

What is the general definition of dementia?

A

Significant cognitive decline

interfering with daily activities

not explained by other processes

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3
Q

Dementia tends to be a (sudden / progressive) disease.

A

progressive decline in cognition

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4
Q

Which percentage of over 65s have been diagnosed with dementia?

A

Around 7%

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5
Q

What is one of the biggest risk factors for developing dementia?

A

Increasing age

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6
Q

Which infections can cause dementia?

A

HIV

Syphilis

Prion disease (i.e contact with the misfolded protein)

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7
Q

What acute neurological diseases cause a decline in cognition?

A

Viral encephalitis

Head injury

Stroke

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8
Q

What are the symptoms of transient global amnesia?

A

Amtegrade amnesia (difficulty laying down new memories)

Retrograde amnesia (loss of short term memories)

but preserved knowledge of self

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9
Q

Transient global amnesia typically lasts how long?

A

4 - 6 hours

Never more than 24 hours

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10
Q

What can trigger transient global amnesia?

A

Emotions

Changes in temperature

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11
Q

Which type of amnesia is short-lived compared to transient global amnesia but tends to be a recurrent problem?

A

Transient epileptic amnesia

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12
Q

Which brain structure is found in the temporal lobe and has a role in learning and memory?

A

Hippocampus

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13
Q

What is the clinical name for ‘everyday forgetfulness’ which impacts daily living?

A

Functional cognitive impairment

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14
Q

What is the course of functional cognitive impairment (‘everyday forgetfulness’)?

A

Fluctuating

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15
Q

What are the courses of

a) functional cognitive deficit
b) dementia?

A

a) Fluctuating

b) Progressive decline

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16
Q

What disorders need to be excluded in forgetful patients?

A

Dementia

Mood disorders

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17
Q

What is a prion disease?

A

Disease caused by misfolded proteins

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18
Q

What is a well-known prion disease causing rapid brain degeneration?

A

Creutzfeldt-Jakob disease (CJD)

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19
Q

In which age of patient does CJD tend to present?

A

60s

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20
Q

What are the clinical features of sporadic CJD?

A

Rapid onset dementia

Myoclonus

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21
Q

What is the average life expectancy of a patient diagnosed with CJD?

A

4 months

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22
Q

What is the cause of CJD?

Study These Flashcards
A

Misfolded protein

23
Q

What investigations are used to diagnose CJD?

Study These Flashcards
A

EEG

MRI brain

Lumbar puncture (CSF markers)

24
Q

What is a common disease causing gradual-onset dementia?

Study These Flashcards
A

Alzheimer’s disease

25
**Alzheimer's disease** is a ____ condition causing dementia.
**neurodegenerative**
26
What are the **clinical features** of Alzheimer's disease?
**Forgetfulness** **Apraxia** **Visual problems**
27
At what age do patients tend to develop **Alzheimer's disease**?
**\> 65**
28
Younger patients who are diagnosed with **Alzheimer's disease** tend to have ___ symptoms.
**atypical** visual disturbances. aphasia
29
What are the **atypical symptoms** of Alzheimer's disease?
**Visual disturbances** (feeling like you're going to step into a pit) **Aphasia** (difficulty communicating, naming things)
30
How is **Alzheimer's disease** investigated?
**MRI brain** - atrophy of temporal lobes **Lumbar puncture** - amyloid in CSF sample (not specific)
31
What neurotransmitter is inhibited in Alzheimer's disease?
**ACh**
32
Which two classes of drugs can give **symptomatic relief** in **Alzheimer's disease**?
**Anticholinesterase inhibitors** (e.g donepezil, rivastigmine) - ACh thought to be involved **NMDA antagonists** - remember that NMDA is involved in excitatory neurotransmission
33
What is a disease causing **early-onset** (i.e \< 65) **dementia with behavioural symptoms?**
**Frontotemporal dementia**
34
What is another name for **frontotemporal dementia**?
**Pick's disease**
35
What are clinical features of **frontotemporal dementia**?
**Loss of inhibition** **Apathy** **Lack of empathy** **Obsessive, compulsive behaviour**
36
Which type of history can be crucial in diagnosing patients with dementia?
**Collateral history**
37
Which lobes are atrophied on the MRI of someone with frontotemporal dementia?
**Frontal / temporal lobes**
38
Patients with **frontotemporal dementia** should have their access to food, money and the internet closely monitored - why?
**Loss of inhibitions**
39
Which type of dementia is linked to the same processes as stroke?
**Vascular dementia**
40
What causes **vascular dementia**?
**Atherosclerosis** \> **Infarct** of areas responsible for memory, processing etc. **Haemorrhage** \> Infarct "" "" ""
41
Which bodies, seen in Parkinson's disease, can also cause a late-onset dementia?
**Lewy bodies**
42
Which protein is implicated to cause **Lewy body dementia**?
**Alpha synuclein**
43
What are the clinical features of **Lewy body dementia**?
**Declining cognition** **Visual hallucination** **Extra-pyramidal 'Parkinsonian' symptoms** - tremor, hypokinesia, rigidity
44
Which scan is used to measure **dopamine** **uptake** from the basal ganglia and can support a diagnosis of **Parkinson's disease** or **Lewy body dementia**?
**DaT scan**
45
What is the name for a dopamine precursor which can be given to reduce symptoms in **PD** and **Lewy body dementia**?
**Levodopa**
46
Which two diseases, involving Lewy bodies and alpha synuclein, can occur together?
**Parkinson's disease** **Lewy body dementia**
47
Which disease, involving CAG triplet repeats, can cause **early-onset** dementia in patients aged 30 - 60?
**Huntington's disease**
48
Which gene is affected in Huntington's disease?
**Huntingtin**
49
What are the symptoms of **Huntington's disease** w/ dementia?
**Chorea** (rhythmic muscle contractions) ## Footnote **Decline in cognition**
50
How is **Huntington's disease** treated?
Symptomatically
51
Who tends to manage **dementia** in a) under 65s b) over 65s?
**a) Neurology** **b) Psychiatry**
52
Who tends to see patients with **rapid-onset dementia** or **dementia with unusual symptoms?**
**Neurology**
53
How is **cognition** assessed?
**ACE-III screen**
54
Which types of **dementia** are associated with ## Footnote **a) Lewy bodies** **b) Alpha synuclein** **c) CAG repeats** **d) prions** **e) tau proteins?**
a) **Dementia with Lewy bodies** (and Parkinson's disease) ## Footnote **b) " "** **c) Huntington's disease** **d) Creutzfeldt-Jacob disease** **e) Alzheimer's disease**

Neurology Week 5 2018/19 (11 decks)

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