dementia

Question 1

dementia

Answer 1

memory - repetitive temporal gradient amnesia
- difficult to learn new things

functionla ability
- easily muddled

personality alter, empathetic, lack of emotion, disinhibited, change in food preference

language - rememebering names

visuosaptial - lost in familiar spaces

pscyh features - depression

how fast are there declining

Question 2

tests for dementia

Answer 2

MMC

ACE - addenbrooks cognitive examination

primitive reflexes
limb paraxis - cant they copy ypur hand movements

blow out candle

Question 3

blood tests for dementia

Answer 3

blood test - FBC, U&Es, CRP, glucose, TFTs, calcium, LFTs, vit B12

Question 4

imaging on dementia

Answer 4

CT/MRI

radionucleide

LP

EEG

neuropshcy

Question 5

gold standard for alzheimers

Answer 5

LP - CSF examination - reduced amyloid beta 42, raised tau protein

Question 6

MRI

Answer 6

shrunking of temporal

Question 7

fronto-temporal dementia another name Picks

Answer 7

frontal

temporal - lack of coherent speech

Question 8

CJD sporadic

Answer 8

chorea - myoclonic

Question 9

dementia treatment

Answer 9

reversible causes hydrocephalus, frontal meningiomas

Question 10

medication for dementia

Answer 10

donepezil, galantamine - acetylocholinesterase inhibitors - mild to moderate alzheimer

Salivation
Lacrimation
Urination
Diarrhoea
GI
Emesis

2nd line memantine - NMDA receptor antagonist as in alzheimer make loads of glutamate

deal with psych issues
inform DVLA
power of attorney

Question 11

what to do before giving medication for dementia

Answer 11

ECG

Question 12

Diagnostic criteria for dementia

Answer 12

impairment at least two cognitive domains - memory, language, behaviour, visuospatial, executive function

Question 13

path features of alzheimer

Answer 13

amyloid plaques
neurofibrillary tangles
atrophy of cerebral cortex

Question 14

what do you have dementia

Answer 14

mild cognitive impairment

Question 15

what is MCI

Question 16

WHY early diagnosis

Answer 16

Optimising medical management
Relief gained
Maximising decision making autonomy
Access to care and services
Risk reduction
Clinical and cost effectiveness
A human right?

Question 17

types of cognitive assessment screen

Answer 17

6-item Cognitive Impairment Test (6-CIT)*
Mini-Cog*
10-CS*
GPCOG
MMSE

Question 18

basic ADLS include

Answer 18

Ambulating: The extent of an individual’s ability to move from one position to another and walk independently.
Feeding: The ability of a person to feed oneself.
Dressing: The ability to select appropriate clothes and to put the clothes on.
Personal hygiene: The ability to bathe and groom oneself and to maintaining dental hygiene, nail and hair care.
Continence: The ability to control bladder and bowel function
Toileting: The ability to get to and from the toilet, using it appropriately, and cleaning oneself.

Question 19

instrumental ADLs

Answer 19

Transportation and shopping: Ability to procure groceries, attend events Managing transportation, either via driving or by organizing other means of transport.
Managing finances: This includes the ability to pay bills and managing financial assets.
Shopping and meal preparation. ie everything required to get a meal on the table. It also covers shopping for clothing and other items required for daily life.
Housecleaning and home maintenance. Cleaning kitchens after eating, maintaining living areas reasonably clean and tidy, and keeping up with home maintenance.
Managing communication with others: The ability to manage telephone and mail.
Managing medications: Ability to obtain medications and taking them as directed.