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dementia Flashcards

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1
Q

what age is classed as early onset alzheimers

A

<65

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2
Q

how is beta amyloid produced

A

cleavage of APP

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3
Q

what is a lewy body

A

intracytoplamic eosinophiic inclusion with dense core surrounded by alpha-synuclein fibrils

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4
Q

what atrophys first in huntingtons disease

A

basal ganglia - partic caudate nucelus

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5
Q

micropathophysiology in huntingtons

A

degen of striatal nucelus - l oss of inhibitory regulatory of motor activity

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6
Q

what are pick cells and picks bodies and when are they seen

A

cells = swollen neurons seen in frontotemporal dementia
bodies = intracytoplasmic filamentous inclusions

seen in frontotemporal dementia (picks disease)

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7
Q

Focal gyral atrophy with a knife-blade appearance is characteristic of what dementia

A

picks disease

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8
Q

what lobes atrophy in picks

A

frontal first and temporal

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9
Q

what happens in transient global amnesia

A

transient (4-6 hours) abrupt onset anterograde amnesia - cant make new memeories

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10
Q

treatment of myathenic crisis

A

plasmaphoresis
IVIG

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11
Q

symptoms of temporal lobe seizure

A

A sudden sense of unprovoked fear or joy
A deja vu experience — a feeling that what’s happening has happened before
A sudden or strange odor or taste
A rising sensation in the abdomen, similar to being on a roller coaster

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12
Q

in what dementia may cognition be fluctuating

A

lewy body

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13
Q

treatment of lewy body dementia

A

anti cholinesterase inhibitors

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14
Q

dx of lewy body

A

clinical
DAT/SPECT

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15
Q

what casues CJD

A

prion proteins

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16
Q

features of CJD

A

rapid onset dementis
myoclonus

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17
Q

investigations in CJD

A

CSF
EEG
MRI

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18
Q

most common CJD

A

sporadic

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19
Q

what causes variant CJD

A

eating meat form a cow with
mad cow- bovine spongiform encephalopathy

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20
Q

what is the hallmark of CJD

A

spongiform change

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21
Q

mean feature of posterior cortical atrophy

A

visual agnosia - man who thought wife was a hat
terry pratchett

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22
Q

features in primary prgoressive aphasia

A

semantic (naming memory) - language goes first

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23
Q

what mmse score indicates dementia

A

<24

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24
Q

what NCIE recommended scoring systems are used for dementia and score

A

10-CS 0-5 =cog impair

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25
what test is used to assess delirium and score is indicitive
4AT and >4
26
what blood tests are doen in dementia
FBC U&E LFT TFT B12/folate Calcium Glucose ESR/CRP
27
first line sedative in delirium
0.5mg haloperidol
28
treatment of delirium in parkansonian patients
reduce parkinson meds or olanzapine
29
management of severe alzheimers
memantine
30
first line option is alzheimers
acetylcholinesterase inhibs donepezil rivastigmine galantamine
31
when is donepezil contraindicated
in patients with bradycardia
32
how many mediations is classed as polypharmacy
4+
33
what type of dementia shows fluctuating cognition
lewy body
34
what questionnarie is used for frailty
PRISMA-7
35
for non cell cycle secific antibiotics what is more important dose or duration
dose
36
side effect of cisplatin
ototoxicity nephrotoxicity peripheral neuropathy hypomagneium
37
side effects of vincrsitine
peripheral neuropathy
38
side effects of cyclophosphamide
haemorrhagic cystitis myelosuppresion bladder cancer
39
management of neoplastic spinal cord comrpession
dexamethasone
40
what cancer is most commonly associated with superior vena cava compression
lung
41
features of SVC compression
dyspnoea is the most common symptom swelling of the face, neck and arms - conjunctival and periorbital oedema may be seen headache: often worse in the mornings visual disturbance pulseless jugular venous distension
42
tumour marker for breast cancer
CA 15-3
43
tumour marker forr colorectal cancer
carcinoembronic antigen (CEA)
44
treatment for agitation in pallative care
haloperidol midazolam in terminal phase
45
tx of hiccups in palliative care
chlorpromazine
46
empirical anti emetic in palliative care
metoclopramide
47
in chemically mediated nausea in palliative care what is used
ondansetron, haloperidol and levomepromazine
48
what should be given for palliative nausea in cerebral mets
cyclizine and dex
49
palliative nausea TX in vestibular symtpoms
cyclizine
50
in palliative care in cortical nausea- due to anxiety, pain, fear and/or anticipatory nausea what anti-emetic should be given
benzos if not cyclizine
51
what route should be taken for palliative care anti emetics if oral not available
parenteral
52
example of pain regime in palliative care
20-30 mg MR morphine and 5mg breakthrough morphine GIVE LAXATIVE - nausea and drowsy should be transient
53
what ratio of morphine is breakthrough compared to daily dose
one sixth eg 5mg for 30mg
54
what pain medication is given in palliative care in mild renal impairement
oxycodone
55
what palliative care medication is given in severe renal imapirement
alfentanil, fentanyl, buprenorphine
56
how much can you increase an opiate dose by
30-50%
57
if switching codeine/tramadol to morphine what should you do to dose
divide by 10
58
when switching oral morphine to oral oxycodoe what should you do to the dose
divide by 1.5/2
59
what shoudl you do to dose when switching oral morphine to subcut
half it
60
palliative treatment of secretions
hyoscine
61
conversion of oral morphine to sucut diamorphine
divide by 3
62
blood screen in demetia patient
FBC, U&E, LFTs, calcium, glucose, ESR/CRP, TFTs, vitamin B12 and folate levels

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