Cognitive Neurology

Question 1

define cognition

Answer 1

the mental action of acquiring knowledge through thought, experience and senses

Question 2

name the different domains of cognition

Answer 2

memory
executive function eg decision making/problem solving
language
social function
attention

Question 3

dementia is defined as significant cognitive decline in at least _ cognitive demain

Answer 3

1

Question 4

a viral encephalitis will affect what cognitive domains?

Answer 4

memory
behaviour change
language

Question 5

a head injury will affect what cognitive domains?

Answer 5

attention
memory
executive dysfunction

Question 6

what are the features of transient global amnesia

Answer 6

abrupt onset antegrade amnesia with preserved knowledge of self that lasts <24 hours
usually only happens once

Question 7

who gets transient global amnesia?

Answer 7

> 50

Question 8

what is anterograde amnesia?

Answer 8

loss of ability to create new memories after the event that caused the amnesia

Question 9

what are the features of transient epileptic amnesia?

Answer 9

forgetful, repetitive questioning
very short lived (20-30mins)
recurrent

Question 10

transient epileptic amnesia is associated with what problem?

Answer 10

temporal lobe seizures

Question 11

patient completes complex tasks but has no memory of doing them….

Answer 11

transient epileptic amnesia

Question 12

what infections can cause cognitive impairment?

Answer 12

HIV syphilis

Question 13

metabolic causes of cognitive impairment?

Answer 13

thyroid
calcium
hyponatraemia

Question 14

everyday forgetfulness impacting on functioning indicates…

Answer 14

functional cognitive impairment

Question 15

presentation of functional cognitive impairment

Answer 15

fluctuating symptoms in a highly functioning person

symptoms can get better or worse unlike in dementia

Question 16

what should be excluded in a patient with suspected functional cognitive impairment

Answer 16

mood disorder

dementia

Question 17

most common human prion disease?

Answer 17

creutzfeldt-jakob disease (CJD)

Question 18

what happens in prion disease?

Answer 18

neurodegenerative proteinopathy of the prion protein

Question 19

most common type of CJD? what age does it present in

Answer 19

sporadic

60s

Question 20

clinical features of sporadic CJD?

Answer 20

rapid onset dementia
neurological signs
myoclonus
death very quickly (4 months)

Question 21

most likely cause of CJD in young people?

Answer 21

genetic

Question 22

patients with functional cognitive impairment tend to have had very good memories before the onset of their symptoms T or F

Answer 22

T

Question 23

Ix of prion disease?

Answer 23

MRI

LP

Question 24

histopathological appearance of CJD

Answer 24

spongiform changes as a result of neuron loss

Question 25

main pathology in dementia syndromes

Answer 25

neurodegenerative proteinopathy

Question 26

early onset alzheimers is onset before age __

Answer 26

65

Question 27

alzheimers shows degeneration of what parts of the brain?

Answer 27

medial hippocampus | parietal lobes later

Question 28

night blindness and visuospatial disturbance in a patient with alzheimers indicates what kind of brain pathology

Answer 28

posterior cortical atrophy

Question 29

a patient with posterior cortical atrophy would struggle with what part of the addenbrookes test?

Answer 29

drawing shapes

Question 30

what is the most common form of progressive primary aphasia in alzheimers patients?

Answer 30

difficulty repeating sentences (logopenic aphasia)

Question 31

"staccato speech" is common in what form of dementia?

Answer 31

fronto-temporal

Question 32

Ix of alzheimers

Answer 32

MRI SPE-CT LP

Question 33

CSF findings in alzheimers?

Answer 33

reduced amyloid | increased tau protein

Question 34

Tx of alzheimers?

Answer 34

address vascular risk factors | acetylcholine agonists eg cholinesterase inhibitors

Question 35

frontotemporal dementia is a/an ___ onset dementia

Answer 35

early

Question 36

what are the early features of FT dementia?

Answer 36

early frontal features eg disinhibition, apathy, loss of empathy, behaviour issues semantic aphasia (naming problems) loss of insight

Question 37

pick bodies are present in what dementia

Answer 37

FT

Question 38

increased tau and normal amyloid on CSF indicates what dementia

Answer 38

FT

Question 39

MRI of FT dementia presents with atrophy of the ____ lobes

Answer 39

frontotemporal

Question 40

Tx of FT dementia?

Answer 40

trazadone | antipsychotics

Question 41

vascular dementia is __ onset

Answer 41

late

Question 42

Tx of vascular dementia?

Answer 42

vascular risk factors +/- | cholinesterase inhibitor

Question 43

presence of extrapyramidal features is a sign of what dementia?

Answer 43

lewy body

Question 44

parkinsons dementia is most similar in presentation to what dementia?

Answer 44

lewy body dementia

Question 45

huntingtons presents with __ onset dementia

Answer 45

early

Question 46

loss of caudate heads on MRI...

Answer 46

late huntingtons dementia

Question 47

symptoms of huntingtons dementia

Answer 47

frontal problems from dysexecutive syndrome | slowed speed of processing

Question 48

Tx of huntingtons dementia

Answer 48

mood stabilisers | chorea management

Question 49

what dementia patients should be referred to old age psychiatry?

Answer 49

>65 | gradual onset

Question 50

what dementia patients should be referred to neurology?

Answer 50

<65 | any unusual features

Question 51

name the components of a dementia blood screen

Answer 51

``` B12 TFTs syphilis HIV Ca genetics ```