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Dementia Flashcards

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1
Q

what can FAB (frontal-assessment battery) test distinguish between?

A

Fronto-temporal dementia + Alzheimer’s dementia

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2
Q

Alzheimer’s dementia is…

A

a progressive degenerative disease of the brain, accounting for the majority of dementia seen in the UK

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3
Q

How is cognitive testing important in the diagnosis of Dementia?

A

differentiates between the different types of dementia

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4
Q

name 3 cognitive function test and mood disorder scales that can be used

A
  1. FAB test = Frontal lobe Assessment Battery
  2. MMSE = mini mental state examination
  3. MoCA = Montreal Cognitive assessment
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5
Q

findings on MRI scan in Alzheimer’s dementia

A

Bilateral atrophy of temporal lobes + generalised atrophy

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6
Q

3 instruments to assess functional symptoms

A
  • activities of daily living questionnaire
  • functional activities questionnaire
  • bristol functional assessment
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7
Q

2 instruments to assess psychological symptoms

A
  • BRHAVE-AD

- Neuropsychiatric inventatory

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8
Q

1 instrument to assess care-giver strain

A

MBRC caregiver strain instrument

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9
Q

2 main subtypes of dementia

A

subcortical + cortical

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10
Q

3 types of cortical Dementia

A
  1. Alzheimer’s dementia
  2. Lewy Body dementia/Parkinson’s dementia
  3. Fronto-temporal dementia
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11
Q

3 types of Subcortical dementia

A
  1. Vascular dementia
  2. Alcohol related dementia
  3. Parkinson’s dementia
  4. Huntington’s dementia
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12
Q

Role of anterior + inferior temporal lobes?

A

semantic memory

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13
Q

Role of lateral temporal lobe?

A

Wernicke’s area

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14
Q

Role of medial temporal lobe?

A

Hippocampus: forming memories + anterograde amnesia

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15
Q

3 features Dementia is marked by?

A
  1. Impaired reasoning
  2. Personality changes
  3. Memory disorders
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16
Q

most common type of dementia?

A

Alzheimer’s dementia

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17
Q

2nd most common type of dementia

A

vascular dementia

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18
Q

Alzhemer’s dementia is more common in males/females

A

females

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19
Q

Vascular dementia is more common in males/females

A

males

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20
Q

Lewy Body dementia is more common in males/females

A

no difference between genders

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21
Q

risk factors for Dementia

A
  • depression in mid-life/later-life
  • head injuries in Parkinson’s dementia
  • lifestyle factors; smoking, alcohol, exercise, education
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22
Q

what ages are early + late onset Alzheimer’s dementia defined by

A

early onset = < 65 years old (30-60)

late onset = > 65 years old

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23
Q

3 exclusion criteria for Dementia

Study These Flashcards
A
  1. absence of dementia
  2. symptoms present > 6 months
  3. Irreversible
24
Q

3 genes identified for Early onset Alzheimer’s dementia

Study These Flashcards
A
  1. Amyloid precursor protein (on chromosome 21)
  2. Presenilin 1 (on chromosome 14)
  3. Presenilin 2 (on chromosome 1)
25
inheritance pattern of the genes in Alzheimer's dementia, and what are these genes involved in?
autosomal dominant metabolism of amyloid protein
26
gene identified for Late onset Alzheimer's dementia
ApoE = Apolipoprotein E | occurs in 3 different alleles
27
pathophysiology of Alzhemer's dementia
loss of anticholinergic activity
28
2 characteristic pathological changes in AD
1. Beta amyloid plaques between neurones | 2. Neurofibrillary tangles of hypophosphorylated tau inside neurones
29
3 A's of cortical dysfunction
A - Aphasia A - Agnosia A - Apraxia
30
gene linked to Vascular dementia in rare cases?
NOTCH3 on chromosome 19
31
7 risk factors for VD
- obesity - smoking - previous stroke - AF - hx MI - raised cholesterol - DM
32
symptoms of small vessel disease affecting the sub-cortex
- personality changes - thought slowness - affective symptoms - executive skills e.g planning, decisions
33
what are Lewy bodies
neuronal inclusions composed of proteins aggregated with ubiquitin + alpha-synuclein
34
location of lewy bodies in lewy body dementia
substantia nigra
35
medx avoided in Lewy Body dementia
neuroleptics
36
3 features of Lewy Body dementia
- progressive cognitive impairment - Parkinsonism - visual hallucinations
37
scan that can be used to diagnose Lewy body dementia
DaT scan
38
pathophysiology of fronto-temporal dementia
intracellular clumps of protein: Tau + TDP-43
39
features of frontotemporal dementia and the causative area:
Atrophy of anterior temporal lobe = agnosia + dysphasia Atrophy of frontal lobe = behavioural problems, emotional control, planning, motor function
40
3 genes associated with Frontotemporal dementia
C90RF72 - chromosome 9 - linked to MND MAPT - chromosome 17: gene for protein Tau GRN - chromosome 17
41
1st line management of AD
AchE-I inhibitors - rivastigmine - donepezil - Galantamine
42
2nd line management of AD
Memantine | NDMA receptor antagonist
43
what are BPSD's
Behavioural and psycological symptoms of dementia
44
investigations to do prior to starting either cholinesterase inhibitors or NDMA receptor antagonists
ECG | U + E
45
cholinesterase inhibitors and contraindicated for:
those with - bradykinesia - LBBB - prolonged QTc interval
46
importance of checking U + E before starting Memantine
can cause renal failure
47
cholinesterase inhibitors used in caution in;
- gastric ulcers | - seizures
48
6 therapy managements for BPSDs
1) cognitive stimulation therapy 2) CBT 3) Reminiscence therapy 4) Aromatherapy 5) Sensory stimulation 6) Music therapy
49
when to offer antipsychotics to patients with dementia
- at risk to harming themselves | - experiencing agitation, hallucinations, delusions that are causing severe distress
50
pathological feature associated with Lewy Body Dementia
Alpha Synuclien
51
which cognitive function test is an extension of the MMSE
ACE - III
52
5 cognitive domains of ACE-III
1. attention/orientation 2. memory 3. language 4. verbal fluency 5. visuospatial skills
53
list of BPSDs
- hallucinations - delusions - anxiety - agitation + aggressive behaviour - apathy - depressioon - irritability
54
Mild diagnosis of Dementia - MMSE - ADL
MMSE 20-24 | Able to manage independant life
55
Moderate diagnosis of Dementia - MMSE - ADL
MMSE 10-20 | Need help with ADLs
56
Severe diagnosis of Dementia
MMSE < 10 | Completely dependant for ADLs
57
4 options for 24 hour care
- General residential home - EMI residential home - General nursing home - EMI nursing home

Psychiatry (9 decks)

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