Dementia

Question 1

what is the leading cause of dementia?

Answer 1

alzheimer’s disease

Question 2

what is the main risk factor for AD?

Answer 2

age

Question 3

the prevalence of AD increase after the age of ?

Answer 3

60 years

Question 4

mutations in what genes cause AD?

Answer 4

APP or PSEN or apolipoprotein E4 allele variants

Question 5

ApoE2 ————- risk

Answer 5

decreases

Question 6

ApoE4———— risk

Answer 6

increases

Question 7

patients with which genetic condition have an increased risk of developing AD?

Answer 7

Down syndrome

Question 8

injuries to which part of the body can increase risk of developing AD?

Answer 8

head

Question 9

what is the histological presentation of dementia?

Answer 9

excess accumulation of extracellular B-amyloid plaques and intracellular neurofibrillary tangles (aggregates of Tau protein)

Question 10

there is widespread —————– atrophy

Answer 10

cortical

Question 11

there is —————- of gyri and —————– of sulci

Answer 11

narrowin and widening

Question 12

what are the areas of the brain which can be first affect in AD? (3)

Answer 12

nucleus basalis of meynert

entrohinal cortex and hippocampus

Question 13

there is ——— and ———– onset of worsening memory in AD

Answer 13

insidious and progresssive

Question 14

early symptoms of AD reflect impairment of which type of memory?

Answer 14

episodic memory

Question 15

AD is not associated with?

Answer 15

behavioural or personality changes

Question 16

with AD there are often early subtle impairments of? (4)

Answer 16

planning, decision making, working out complex sequences and learning new tasks

Question 17

as the AD progresses there are difficulties with?

Answer 17

languae, bheavioural problems (such as aggression), depression and disorientation becomes more pronounced

Question 18

what tools are used for diagnosis?

Answer 18

MMSE, MRI and SPECT scan

Question 19

what are the CSF biomarkers in AD?

Answer 19

increase in phosphorylated tau protein and decrease in B-amyloid

Question 20

what do you use to treat patients with AD (mild to moderate)

Answer 20

acetylcholinesterase inhibitors (donepezil,galantamine or rivastigimine)

Question 21

what is used for patients who are intolerant of or have a contraindication to EChE inhibitors or have severe AD?

Answer 21

memantine

Question 22

what type of drug is menantine?

Answer 22

voltage dependent non-competitive N-methyl-D-aspartate (NMDA) receptor antagonist

Question 23

what are thee complications of AD?

Answer 23

haemorrhagic stroke due to B-amyloid deposits in cerebral blood vessels that can weaken them

Question 24

haemorrhagic stroke due to B-amyloid deposits in cerebral blood vessels that can weaken them

Answer 24

cerebral amyloid angiopathy

Question 25

what is frontotemporal dementia?

Answer 25

group of neurodegenerative disorders characterised by relatively focal frontal and temporal cerebral atrophy

Question 26

what are teh three broad syndromic variants of frontotemporal dementia?

Answer 26

behavioural variant semantic dementia progressive non-fluent aphasia

Question 27

what is the most common type of fTD?

Answer 27

behaviouraal variant

Question 28

what are the symptoms of FTD?

Answer 28

loss of inhibition , apathy, repetitive behaviours and diffulty planning

Question 29

what is characteristic of FTd behvaaioural variant/

Answer 29

memory is preserved in early disease and behavioural symptoms are more pronounced

Question 30

what are the two forms of primary progressive aphasia?

Answer 30

semantic dementia | and progressive non-fluent aphasia

Question 31

what is semanitc dementia?

Answer 31

impaired word comprehension and object naming | loss of recognition of familiar faces or objects

Question 32

impaired word comprehension and object naming | loss of recognition of familiar faces or objects

Answer 32

semantic dementia

Question 33

what is progressive non-fluent aphasia?

Answer 33

slow/hesitant speech, word finding deficits and agrammatism. may be associated orofacial apraxia

Question 34

slow/hesitant speech, word finding deficits and agrammatism. may be associated orofacial apraxia

Answer 34

progressive non-fluent aphasia

Question 35

how can orofacial apraxia be tested?

Answer 35

coughing or swallowing

Question 36

what investigation can be used to diagnose FTD?

Answer 36

MRI and lumbar puncture

Question 37

what is the second most common form of dementia?

Answer 37

vascular dementia

Question 38

what caauses vascular dementia?

Answer 38

vascular changes secondary to cerebrovascular disease

Question 39

what are the symptoms of vascular dementia?

Answer 39

executive and attentional impairments, behavioural changes (disinhibition), cognitive slowing, focal neurological problems and difficulty walking/falls

Question 40

what is the most appropriate imaging modality used to diagnose vascular dementia?

Answer 40

MRI

Question 41

what does MRI show in vaascular dementia?

Answer 41

the presence and location of infarcts and commonly shows white matter changes and patchy reduced attenuation in the cortex

Question 42

what is creugzfeldt-Jakob disease?

Answer 42

it is a transmissible prion neurodegenrative disease

Question 43

what does the prion cause in CJD?

Answer 43

cell death (spongiform changes in the cortex) and astrocytosis

Question 44

what doees CJD present with?

Answer 44

rapidly progressing dementia, ataxia and myoclonic jerks

Question 45

what is the best initial test for CJD/

Answer 45

EEG

Question 46

what is the charateristic feature of EEG in CJD/

Answer 46

pseudoperiodic sharp wave activity

Question 47

what does CSF analysis show in CJD?

Answer 47

elevated 14-3-3 protein