Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

NEUROLOGY 1a > 1b Dementia > Flashcards

1b Dementia Flashcards

1
Q

What is the most commonest form of dementia?

A

Alzheimers Disease

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

What is Dementia?

A

A fatal neurodegenerative disorder which is characterised by progressive cognitive, social and functional impairment

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

What has the most modest symptomatic benefit in early stages?

A

Acetylcholinesterase inhibitors

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

What two forms of dementia are most likely to occur together?

A

Vascular and Alzheimers

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

What are the stages of dementia on the continuum scale?

A

Preclinical -> MCI -> Dementia

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

Which of B1, B6 and B12 deficiencies can particularly reduce cognitive function?

A

B12

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

What occurs in the preclinical stage of declining cognitive function?

A

Deterioration of someone’s cellular function without clinical manifestation

Eg. Increase in Amyloid
Increase in Tau B
Neuroinflammation

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

Give examples of some of the endocrine causes of dementia?

A

Hypothyroidism - thyroid hormones induce changes in amyloid precursor processing or deposition of amyloid-beta

Cushing’s

Addison’s

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

Why is it hard to accurately diagnose dementia in clinic?

A

The disease follows a heterogenous course

In old age the disease presentation is of multiple co-morbidities

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

Are younger patients or older patients more typical in dementia?

A

Younger patients are more typical

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

Why is it harder to diagnose Dementia with older aged patients?

A

In old age the disease presentation includes a lot of different co-morbidities

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

What does the clinical diagnosis of Dementia lie most in?

A

History Taking

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

Dementia risk factors?

A

Ageing

Brain trauma

Oral health

Genetic factors

Midlife obesity

Reduced physical activity

Infections or systemic inflammation

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

What aspect of memory is impaired in dementia?

A

Short term memory

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

What is the checklist of things to ask patients and collateral in the interview?

A

Memory

Language - communicate how they feel and for diagnosis

Numerical skills - calculating finances and pay bills

Executive skills

Visuospatial skills - acidentally backing into other people’s cars

Neglect phenomena

Visual perception

Route finding and landmark identification

Personality and social conduct - knowing personality before symptoms start

Sexual behaviour - as alzheimers and temporal dementia develop they feel less-inhibited

Eating

Mood

Motivation/Apathy

Anxiety/Agitation

Delusions

Activities of daily living

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

Why is it important for physicians to interview collateral as well as the patient?

A

Typically patients will deny any symptoms and say that their decline is normal for someone of their age

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the definition of dementia?

A

Severe loss of memory and cognitive abilities which leads to impaired daily function (regardless of the underlying cause)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Which examination should be done for dementia?

A

Neurological Mental State

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Which investigations should you do for Dementia?

A

Neuropsychology
Bloods
MRI
PET

20
Q

When is a PET scan useful to conduct?

A

When the patient is not likely to have Alzheimer’s disease but a scan is still needed to rule it out

21
Q

What is a straightforward cognitive test example?

A

MMSE (Mini mental state examination) and ACE III (Addenbrooke’s cognitive examination)

22
Q

What would you take from bloods in an investigation of dementia?

A

Full blood count
Inflammatory markers
Thyroid function
Biochemistry and renal function
Glucose
B12 and folate
Clotting factors

23
Q

Which conditions would you test for in the bloods of a dementia patient to rule them out?

A

Syphilis serology

HIV

Caeruloplasmin

24
Q

Describe changes which you would see on a sMRI of a patient with dementia?

A
  1. Narrow gyri and wider sulci
  2. Dilated / enlarged ventricles
  3. Tissue replaced with CSF
  4. Medio-temporal volume loss, Hippocampal volume loss, cerebro-cortical atrophy
25
Q

Which area which has a rich ACh supply will you find extensive neurone loss?

A

nucleus basalis of Meynert (rich in ACh) - therefore lack of supply to the hippocampus, amygdala and neocortex

26
Q

Which chemicals are neuropathic with dementia?

A

Amyloid and Tau

27
Q

How do you measure amyloid and tau?

A

Florbetapir in Vivo is given to a cannulated patient and this is a contrast to light up areas in brain with tau and amyloid

28
Q

What are the differentials for a diagnosis of Dementia?

A

Alzhemiers
Vascular
Lewy Body
FTD
Depression
Delirium
None

29
Q

What are the management options for dementia?

A

Acetylchoinesterase inhibitors
Watch and wait
Treating behavioural and psychological symptoms
OT/Social services
Specialist therapies

30
Q

How does amyloid affect dementia?

A

It is part of the primary event that causes changes in brain structure and specifically, cognition lags

31
Q

Ideally how long should you see successive deterioration in order to be confident in a diagnosis of dementia?

A

6 months - 2 years

32
Q

What is the presentation of Alzheimers described as?

A

Subtle and insidious with amnestic and non-amnestic presentations

33
Q

What is the pattern of decline in vascular dementia?

A

Step wise deterioration

34
Q

What is the development of vascular dementia associated with?

A

CVD

35
Q

What are some symptoms associated with Lewy Body Dementia?

A

Visual Hallucinations
CI before/within 1 year of Parkinsons like symptoms
Fluctuating cognition

36
Q

What symptoms are typical of fronto-temporal dementia?

A

Semantic dementia therefore progressive non-fluent (expressive) aphasia

37
Q

What is the head turning sign?

A

Ask the patient a questions and the patient turns to face their partner as they are unsure of the answer / dont know or need verification

38
Q

What is responsible for episodic memory?

A

Dependent on medial temporal lobes including the hippocampus

39
Q

Features on a scan that are indicative of Dementia?

A

Narrowed gyri

Hippocampal atrophy

Dilated lateral ventricles

40
Q

Which dementia typically involves initial episodic memory deficits secondary to dysfunction of medial temporal lobe structures (entorhinal cortex and hippocampus)?

A

Alzheimers

41
Q

What is the pattern of biomarker decline in alzheimers?

A

As the disease stage progresses:

First, Amyloid
Tau
Changes to brain structures
Lastly, Cognition

42
Q

What are some typical signs / symptoms of Lewy Body Dementia?

A

High Risk of Falls
Visual Hallucinations - Generally people / animals
REM Sleep Disorder
Associated with fluctuating Cognition
Development of Parkinsons like symptoms

43
Q

What is Lewy body dementia generally caused by?

A

The aggregation of alpha synuclein, leading to deposition of Lewy bodies and internal symptoms

44
Q

What are the radiological changes in dementia with Lewy Bodies?

A

Preserved hippocampal volume and median-temporal volume

45
Q

What happens to the caudate and putamen in Lewy Body Dementia?

A

Decreased availability of dopamine transporters in the caudate and putamen

46
Q

What radiological signs do patients with FTD show?

A

Perisylvian volume loss
Volume loss in temporal lobes and frontal opercula

47
Q

What are some signs and symptoms of FTD?

A

Increased behavioural disturbances
Agitation, Anger and Rudeness
Impaired Speech - dysfluent, agrammatic, paraphrasic errors, anomia (Unable to name everyday objects), neologisms (joining words together to make new words which do not exist)
Difficulty doing gesture
Obsessive Behaviours

NEUROLOGY 1a (21 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions