Dementia

Question 1

Risk factors for vascular dementia

Answer 1

Smoking

HPT

Diabetes

Previous CVAs, MIs, TIAs IHD, PVD

Question 2

Aphasia

Answer 2

Language and communication deficit

Question 2

Difference between dementia and delirium

Answer 2

Dementia vs Delirium: Chronic vs acute

Insidious vs rapid

Progressive vs fluctuating

Long vs short duration

Level of consciousness - worse in delirium

Uncommon vs common hallucinations

Irreversible vs reversible

Question 2

Pharmacological management of Alzheimer’s

Answer 2

HRT (in women)

Vitamin E

Cholinesterase inhibitors

Psychotropic agents for residual symptoms

Question 3

Gross neuropathology in Alzheimer’s

Answer 3

Brian shrinkage

Enlarged ventricle

Deep sulci

Thinning of cortex

Question 4

3 types of dementia

Answer 4

Cortical - intellectually based e.g. Alzheimer’s

Subcortical - movement based e.g. Parkinson’s

Fronto-temporal - behaviour based e.g. Pick’s

Question 4

Neuronal changes in Alzheimer’s

Answer 4

Deposition of beta-Amyloid protein - extracellular plaques - neurofibrillary tangles

Question 5

Risk factors for Alzheimer’s

Answer 5

Age

Family history

Head injury

Down’s syndrome

Epilepsy

Question 6

Agnosia

Answer 6

Inability to recognise familiar objects/shapes

Question 8

Apraxia

Answer 8

Inability to perform purposeful actions

Question 10

Cognition

Answer 10

The process of obtaining, organising and using intellectual information

Question 11

Which test do dementia patients score better on: MOCA or mini mental?

Answer 11

Mini mental

Question 12

Under what DSM heading is dementia

Answer 12

Major Neurocognitive Disorder

Question 13

3 characteristic criteria of cognitive deficits in dementia

Answer 13

1. Interfere with independence in everyday activities
2. Are not exclusively in the context of a delirium
3. Not better explained by another mental disorder

Question 15

Cognitive domains

Answer 15

CAL(L) ME PLS

Complex Attention

Learning and Memory

Executive function

Perceptual-motor

Language

Social cognition

Question 16

Protective factors for Alzheimer’s

Answer 16

Oestrogen

Vitamin E

Low dose NSAIDs

Intellectual stimulation

Question 17

Difference in progression between Alzheimer’s and vascular dementia

Answer 17

Alzheimer’s - gradual continuous progression

Vascular dementia - stepwise progression

Question 18

Definition of dementia

Answer 18

Significant cognitive decline from a previous level of performance in one or more cognitive domains

Question 19

Ddx for acute loss of consciousness/delirium

Answer 19

AEIOU TIPS:

Alcohol

Epilepsy

Insulin

Overdose

Uraemia/Underdose

Trauma

Infections

Psychogenic

Stroke