Dementia Flashcards

(42 cards)

1
Q

What does Emily suffer from?

A

Hypertension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What medication does she take for hypertension?

A

Amlodipine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is dementia?

A

Syndrome where there is deterioration in memory, thinking, behaviour and the ability to perform everyday activities

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the early signs of dementia?

A

Forgetfulness
Losing track of time
Becoming lost in familiar places

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the middle stages of dementia?

A
Forgetting recent events and names
Becoming lost at home
Difficulty with communication
Needing help with personal care
Behaviour changes e.g. wandering and repeated questioning
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are signs of late stage dementia?

A
Becoming unaware of time and place 
Difficulty recognising loved ones
Need for assisted self care
Difficulty walking
Behaviour changes that escalate includes aggression
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What test did the doctor use to assess Emily’s memory?

A

Six item cognitive repair test

6-CIT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Give some examples of question used in the 6-CIT

A
What year is it?
What month is it?
Give the patient an address to remember with 5 components 
About what time is
Count backwards from 20
Say the months of the year in reverse
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Why was the new scoring system introduced?

A

Gives questions that are appropriate to everyone
E.g. takes into account cultural differences

Allows for a range of marking, accounts for no. of errors made
Not simply right or wrong

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What was the outcome of Emily’s test?

A

Mild cognitive impairment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What’s the deal with mild cognitive impairment?

A

A condition in which someone has minor problems with cognition- their mental abilities such as memory or thinking

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What’s dementia?

A

A syndrome usually chronic or progressive in which there is deterioration in cognitive function beyond what is normally expected

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Which members of the MDT can help Emily?

A
Dementia social worker
Dietician 
Carer
Voluntary service
Specialist nurses 
Physiotherapist
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Why are specialist nurses important?

A

Administrating medication

Taking care of issues e.g incontinence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What can an occupational therapist do?

A

Adapt her environment to her condition
E.g. mat in bath
Chair lift
Specialist kitchen utensils

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Why are members of voluntary services important?

A

Depression
Loneliness
Less reliant on family members

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

At what point would Mrs Wilkins lack capacity to make her own decisions?

A

When she is no longer able to carry out one of the following:

  • understand information
  • retain information
  • weigh up pros and cons
  • communicate their decision
18
Q

What is the basis on the Mental Capacity Act?

A

Everyone has capacity until proven otherwise

19
Q

What must be true for someone to lack capacity?

A

They have an underlying condition that is causing the lack of capacitance

20
Q

Why does making decisions about capacity involve multiple people?

A

It is subjective

Must be signed of by two different doctors independently

21
Q

What if decisions have to made very quickly?

A

Lack of capacitance stands for 24 hours until someone else is able to make an assessment

22
Q

Who makes final decisions regarding adults without capacitance?

A

The medical team

Family’s views should be taken as guidance

23
Q

Why do we assess capacitance on multiple occasions over time?

A

Things change over time
May regain capacity
Or deteriorate and no longer have capacity

24
Q

What are the 4 most common types of dementia?

A

Alzheimer’s
Vascular
Lewy Body
Fronto-temporal dementia

25
What are the classic features of Alzheimer’s?
``` Memory lapses Confusion Gradual onset Better long term memory 50% of dementia cases ```
26
What are the classic features of Vascular dementia?
``` Multiple tiny infarcts due to atherosclerosis Symptoms of stroke e.g. paralysis Traced to cardiovascular problems Step-wise onset 25% of dementia cases ```
27
What are the risk factors for vascular dementia?
``` Hypertension High cholesterol Diabetes Smoking Obesity ```
28
What are the main features of Lewy body dementia?
``` Caused by a build of proteins in the brainstem Parkinson-like symptoms Hallucinations Sleep disorders Confusion Tremor ```
29
What are the main features of Frontal Temporal dementia?
Affects communication and speech Behavioural and personality changes Become disinhibited Very difficult for families
30
How would you explain extracellular amyloid plaques to a patient?
Build up of proteins in your brain | Avoid terms such as growths of lumps that may be associated with cancer
31
How would you explain intracellular neurofibrillary tangles?
Mis-folding of proteins that have malformed that reduces the function of that cell
32
How would you explain synaptic deterioration and neuronal death?
The connections between your nerve cells aren’t functioning properly And some of the cells are dying
33
How would you describe gross cerebro-cortical atrophy?
Due to these processes the volume of certain areas of your brian has been reduced
34
Where are the posterior cingulate cortex?
See diagram Above corpus callosum Posterior side
35
Where is the thalamus?
Centre of brain
36
Where is the hippocampus?
Below the thalamus
37
What are the areas most affected by Alzheimer’s?
Posterior cingulate cortex Hippocampus Anterior Thalamus
38
What is the function implicated by posterior cingulate cortex?
Orientation 6-CIT: Year/ Month/ Time
39
What is the function implicated by hippocampus?
Short term memory 6-CIT: Repeat address
40
What is the function implicated by the anterior thalamus?
Attention 6-CIT: Count back from 20 Say months in reverse
41
From the paper what are the key findings?
Reduced posterior cingulate volume Reduced entorhinal cortex volume Decreased fractional anisotrophy in the parahippocampal cingulum
42
What is the limbic system?
Supports memory, emotion and behaviour | Includes the cingulate gurus, hippocampus, anterior thalamus, entorhinal cortex and other structures