dementia

Question 1

definition

Answer 1

an acquired, progressive impairment of cognition without clouding of consciousness that has been present for at least 6 months.

Question 2

must have had symptoms for?

Answer 2

6 months

Question 3

primary degenerative conditions?

Answer 3

alzheimers, lewey body and picks disease

Question 4

picks disease - what do you find in brain?

Answer 4

picks bodies

Question 5

what kind of demntia is picks?

Answer 5

frontotemperal

Question 6

secondary causes of dementia ?

Answer 6

vascualr dementia 
depression 
HIV 
syphillis
encephalitis 
alcohol and head trauma

Question 7

polymorphisms in which gene are known to contribute to alzheiers

Answer 7

ApoE gene
apoE4 predispose
apoE2 assocaited with longevity in the disease

Question 8

brain changes in alzheimers?

Answer 8

cortical atrophy with thinning of sulci and gyri

Question 9

which lobe is spared in alzheimers

Answer 9

occipital

Question 10

what happens to the ventricles in alzheimers?

Answer 10

enlargement

Question 11

histologically, you get deposition of B amyloid plaques, what can stain these?

Answer 11

stain green with congo red stain

Question 12

what kind of tangles do you get in AD?

Answer 12

neurofibrillary tangles of phosphorylated tau proteins

Question 13

vascular dementia - who is it more common in ?

Answer 13

men with CVD risk

Question 14

what is the pathology?

Answer 14

multiple small vessel infarcts in the brain

Question 15

presentation of vascular dementia?

Answer 15

sudden onset with stepwise progression of symptoms.

symptoms get worse, plateau, get worse, plateau

Question 16

what do you get first in vascular dementia? functional or memory?

Answer 16

functional first then memory

gait disturbance and urinary incontinence

Question 17

what is very prominent in vD?

Answer 17

mood disturbance and mood disorders

Question 18

what scan shows reduced attenuation throughout the brain in vascular dementia?

Answer 18

spect scan

Question 19

what score can be used to differentiate a potential vascular dementia from alzheimers

Answer 19

Hackinski score

Question 20

Lewey body dementia. where do you get degeneration?

Answer 20

substantia nigra and cortex

Question 21

where do you get lewey body deposition?

Answer 21

substantia nigra and cortex

Question 22

LBD characterised by ?

Answer 22

fluctuating cognition with lucid periods and recurrent visual hallucinations

Question 23

what is the main issue in LBD?

Answer 23

executive function, issues seen with multi tasking and performing complex tasks

Question 24

why would symptoms be worsened by taking anti psychotics?

Answer 24

anti psychotics block D2. LBD affects same area as parkinson

Question 25

memory in LBD?

Answer 25

spared until later in disease

Question 26

can get parkinsonsism with early and repeated falls

Answer 26

y

Question 27

what sort of sleep disorders can you get with LBD?

Answer 27

REM

Question 28

LBD lies on a spectrum with ?

Answer 28

parkinsons as it affects same area as brain

Question 29

how do you differentiate PD and LBD?

Answer 29

o Lewy body: cognitive decline before or at the same time as onset of parkinsonism.
o Parkinson’s: onset of cognitive decline at least a year after the onset of parkinsonism.

Question 30

how do you diagnose LBD?

Answer 30

SPECT scan shows low dopamine uptake n basal ganglia

Question 31

age of onset of Picks?

Answer 31

usually younger (less than 70)

Question 32

what are picks bodies?

Answer 32

intra cytoplasmic filamentous inclusions

Question 33

what are picks cells ?

Answer 33

swollen neurones

Question 34

how does picks present?

Answer 34

insight is lost quickly but memory is impaired

Question 35

caused by prion disease, can cause rapid progression in dementia in under 50?

Answer 35

mad cow disease