Alzhemiers Disease

Question 1

What are the pathological features of AD on CT?

Answer 1

Wide sulci
Large ventricles
Atrophy of hippocampus

Question 2

What are the pathological hallmarks of AD

Answer 2

• beta amyloid deposition - plaques
• neurofibrillary tau tangle formation
• neuronal loss

Question 3

What are the symptoms associated with parietal-temporal lobes

Answer 3

Aphasia - inability to comprehend and formulate language
Agnosia - inability to process sensory info
Apraxia - difficulty with motor planning and to carry out learned movements
Apathy - lack of interest, enthusiasm or concern

Question 4

What are the symptoms of frontal lobe AD

Answer 4

Irritability

Disinhibition

Question 5

What are the symptoms of mild AD

Answer 5

Forgetfulness, recent memory deficit

Normal ADLs

Question 6

What are the symptoms of moderate AD

Answer 6

Significant memory loss with personality and behavioural changes
Difficulties in orientation and language begin
Impairment in ADLs

Question 7

What are the symptoms of advanced AD

Answer 7

Dysphasia - disordered and fragmented speech 
Aggression, restlessness, wandering 
Hallucinations and delusions 
Incontinence 
Immobility, rigidity, recurrent falls 
General physical deterioration

Question 8

What is the general treatment for AD

Answer 8

Acetylcholinesterase inhibitors
NMDA antagonist
Antipsychotics

Question 9

Which acetylcholinesterase inhibitors are used and what are their effects

Answer 9

Donepezil, rivastigmine, galantamine
Effects on global change, cognition, function and behaviour
Given because acetylcholine decreases in AD

Question 10

Which NMDA antagonist is given

Answer 10

Memantine 5-20mg per day

For moderate to severe AD

Question 11

What are the risks of using anti psychotics in patients with AD

Answer 11

Increased risk of stroke

Increased risk of mortality

Question 12

What is the psychosocial management

Answer 12

Physical activity
Mental activity 
Social activity 
Healthy diet 
Correct any hearing loss