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Block 12 Ellen > L24: Dementia > Flashcards

L24: Dementia Flashcards

1
Q

main cause of dementia

A

alzheimer’s disease

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2
Q

second commonest dementia

A

mixed

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3
Q

what is mixed dementia

A

Alzheimer’s and vascular

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4
Q

3rd commonest dementia

A

vascular dementia

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5
Q

differential diagnosis (3)

A
  • ageing and mild cognitive impairment
  • depression
  • Delirium (including infection)
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6
Q

five As of alzheimer’s

A
  • amnesia
  • aphasia
  • apraxia
  • agnosia
  • associated features
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7
Q

amnesia=

A

memory

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8
Q

aphasia=

A

speech

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9
Q

apraxia=

A

motor

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10
Q

agnosia=

A

recognition

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11
Q

what part of the brain is most affected by alzheimer’s disease

A

medial temporal and parieto-temporal lobes

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12
Q

what is often spared in alzheimers

A

primary sensory / motor/ visual cortex

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13
Q

what is widened and narrowed in the brain

A

widened sulci

narrowed gyri

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14
Q

2 general terms for the pathophysiology of alzheimers

A

plaques and tangles

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15
Q

what are plaques

A

abnormal processing og amyloid precursor protein leading to excessive beta amyloid

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16
Q

what does abnormal amyloid protein mean (3)

A
  • calcium influx and cell death via glutamate excitotoxicity
  • interference with nerve signalling
  • associated inflammatory response
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17
Q

what are tangles

A

hyper-phosphorylated tau protein

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18
Q

what does tau protein disrupt

A

cerebral architecture and functioning

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19
Q

2 treatments for alzheimers

A
  • acetylcholinesterase inhibitors

- N-methyl D-aspartate (NMDA) antagonists

20
Q

name 3 acetylcholineesterase inhibitors

A
  • donepezil
  • galantamine
  • rivastigmine
21
Q

name 1 NMDA receptor antagonists

A

memantine

22
Q

which drug is used in mild-moderate AD

A

acetylcholinesterase inhibitors

23
Q

what neurotransmitter does NMDA reduce

A

glutamate

24
Q

which drug is used in moderate- severe AD

A

NMDA antagonist -memantine

25
Q

reason for vascular dementia

A

problems with blood supply to brain

26
Q

4 risk factors for vascular dementia

A
  • hypertension
  • raised cholesterol
  • diabetes
  • smoking
27
Q

treatments for vascular dementia

A
  • lifestyle change
  • control of Bp ect
  • Aspirin/ clopidogrel
28
Q

what is MID

A

multiple infarct dementia following a stroke

29
Q

what is MID often associated with

A

physical problems especially posterior circulation

30
Q

what is often preserved in small vessel disease

A

higher cortical functions

31
Q

what would be diagnosis if ; early cognitive symptoms, rapidly progressing dementia, hallucinations and mild parkinsonian features

A

dementia with lewy bodies

32
Q

what would be diagnosis if; motor symptoms >1 year, apathy, slowing of thought and executive functioning, forgetfulness

A

parkinsons disease with dementia

33
Q

what is the difference between DLB and parkinsons disease with dementia

A

which way round the diagnosis is

34
Q

for DLB you need 2 out of 3 of these:

A
  • fluctuations in cognition
  • persistent hallucinations
  • spontaneous parkinsonism
35
Q

what is syncope

A

temporary loss of consciousness

36
Q

what is the pathophysiology of DLB

A

degeneration of brainstem substantia nigra

37
Q

what is the substantia nigra involved in

A

dopamine production

38
Q

what do the remaining nerve cells in DLB contain

A

Lewy bodies

39
Q

where is atropy of the brain common in DLB

4

A
  • midbrain
  • temporal lobe
  • parietal lobe
  • cingulate gyrus
40
Q

when is the onset for frontotemporal dementia

A

early onset mainly

41
Q

what mutation is in the 10% of familial frontotemporal dementia

A

tau gene

42
Q

3 common syndromes of frontotemporal dementia

A
  • frontal lobe atrophy
  • progressive non fluent aphasia
  • semantic dementia
43
Q

what does frontal lobe atrophy effect

A

emotions and behaviour

44
Q

what is progressive non fluent aphasia

A

progressive difficulty in language

45
Q

what is semantic dementia

A

loss of knowledge of meaning of words

46
Q

what does frontotemporal dementia usually present with

A

emotional or behavioural changes (rather than STM loss)

47
Q

what is relatively preserved in frontotemporal dementia

A

memory

Block 12 Ellen (25 decks)

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