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JG Year 2 > 236 Alzheimer's > Flashcards

236 Alzheimer's Flashcards

1
Q

After how many months of symptoms can a diagnosis of dementia be given?

A

6 months

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2
Q

What is praxis?

A

Learned motor tasks

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3
Q

What is gnosis?

A

Ability to recognise objects/faces/sensory information

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4
Q

What is the prevalence of dementia in the UK?

A

3.5%

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5
Q

What is the cause of 50% of dementia?

A

Alzheimers

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6
Q

What are the features of pseudodementia?

A

Awareness that there is a memory loss and ability to date onset
Answering questions with ‘don’t know’
Irritation/despair
May have insomnia/other depressive symptoms

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7
Q

What differentiates delirium from dementia?

A

Delirium usually associated with a physical illness

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8
Q

Name 2 physical illnesses which can cause *dementia/ depression/delerium
*can be reversible
(4 listed)

A

Vitamin deficiencies
Thyroid disease
Hepatic/renal impairment
Normal pressure hydrocephalus

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9
Q

How can B12 deficiency cause dementia?

A

Producing nervous decay with astrocyte accumulation and haemorrhage

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10
Q

What is the mechanism of developing dementia in normal pressure hydrocephalus?

A

Abnormal CSF resorption leading to enlargement of the ventricles + compression of brain tissues. Only intermittently raises CSF pressures above normal range

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11
Q

What are the symptoms of normal pressure hydrocephalus?

3 listed

A

Gait disturbances
Dementia/mental decline
Urinary incontinence

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12
Q

Which allele is associated with increased risk of developing late onset Alzheimers?

A

Apolipoprotein E-4

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13
Q

What are neurofibrillary tangles and which disease are they associated with?

A

Tau protein acting like glue causing the microfibrils to tangle. Associated with AD

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14
Q

What is the consequence of neurofibrillary tangles?

A

The microtubules disintegrate causing cell destruction and death

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15
Q

What are senile plaques?

A

Amyloid plaques in grey matter - seen in majority of elderly by 80 y/o

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16
Q

Which part of the brain is most affected by cerebral cortex atrophy?

A

Association regions

Medial temporal lobe

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17
Q

Where in the brain is cholinergic system dysfunction seen in AD?

A

Loss of cholinergic input to hippocampus and amygdala

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18
Q

Which type of AD is there a mutation in presenilin?

A

Early onset

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19
Q

What is the treatment for mild/moderate Alzheimers?

A

Anticholinesterases e.g.

  1. Donepazil
  2. Rivastigmine
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20
Q

What is the treatment for moderate/severe Alzheimer’s?

A

memantine = NMDA antagonist

21
Q

What is the MOA of memantine?

A

Noncompetitive NMDA receptor antagonist meaning decrease in levels of glutamate in demented brain

22
Q

Name 3 risk factors for vascular demetia

5 listed

A
  • DM
  • Smoking
  • Hypercholesterolaemia
  • HTN
  • Male sex
23
Q

What is the treatment for vascular dementia?

A

Low dose aspirin, statin and management of HTN and glu

24
Q

What are the S+S of Lewy body dementia?

A
  • Fluctuating cognition
  • Vivid visual hallucinations
  • Parkinsonian features
  • Falls
  • Memory loss (may not be a marked feature in early disease)
25
Q

What are Lewy bodies?

A

Clumps of alpha synuclein and ubiquitin proteins in neurones

26
Q

What can normally be seen on a CT brain scan in dementia patients?

A

Global cerebral atrophy and ventricular dilatation

27
Q

What is the protein in neurofibrillary tangles?

A

Hyperphosphorylated tau

28
Q

Which areas of the brain are associated with declarative memory?

A

Medial temporal lobe, thalamus and hypothalamus

29
Q

Which area of the brain is associated with emotional conditioning?

A

Amygdala

30
Q

Which area of the brain is associated with motor learning?

A

Cerebellum

31
Q

Which area of the brain is associated with procedural memory, skills and habits?

A

Striatum

32
Q

Where in the hypothalamus is episodic memory stored?

A

Mamillary bodies

33
Q

What is motor neglect?

A

Fewer movements on the contralateral side of a damaged hemisphere

34
Q

What is conceptual neglect?

A

Neglect of the body and external world on contralateral side to damaged hemisphere

35
Q

What is hemisomatognosia?

A

Patient denies that affected side of body belongs to them

36
Q

What is agnosia?

A

Inability to recognise sensory stimuli

37
Q

What is prosopagnosia?

A

Inability to recognise faces

38
Q

Which area of the brain is associated with the ability to recognise people’s faces?

A

Fusiform gyrus

39
Q

Which area of the brain is damaged if movement agnosia is seen?

A

Middle temporal cortex

40
Q

What is movement agnosia?

A

Patient is unable to distinguish between movements and stationary

41
Q

What is Wernicke’s aphasia?

A

Inability to understand spoken language - they are fluent and grammatically correct but sentences dont make sense

42
Q

What is Broca’s aphasia?

A

Ability to understand language but are unable to produce sentences - altered syntax

43
Q

What is dysarthria?

A

Inability to move muscles of face and tongue in order to produce speech

44
Q

What is apraxia?

A

Inability to complete motor tasks when asked - but can understand

45
Q

Name 3 drugs which can cause hypotension in the elderly

A
  • Amlodipine
  • Bisoprolol
  • GTN spray
  • Furosemide
46
Q

Name 3 types of drugs which can cause confusion in the elderly

A
  • Benzos
  • Opiods
  • TCAs
  • Anticonvulsants
  • Digoxin
  • ACEI
  • Beta-blockers
47
Q

Which antipsychotic can be used in the treatment of sever dementia?

A

Risperidone

48
Q

What is the 1st line treatment for depression?

A

Citalopram

49
Q

Which drug can be used for night sedation in dementia patients?

A

Zopiclone

JG Year 2 (28 decks)

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