Dementia/congenital impairment

Question 0

What is dementia?

Answer 0

Global impairment of cognitive function and personality without impairment of consciousness

Question 1

When is dementia consider early onset?

Answer 1

Before the age of 65

Question 2

How long do symptoms of dementia have to be present for a diagnosis of dementia to be made?

Answer 2

6 months

Question 3

What is the most common cause of dementia?

Answer 3

Alzheimer’s disease

Question 4

What drugs may be used to slow the progress of Alzheimer’s disease?

Answer 4

ACh inhibitors

Question 5

What drugs can cause a Parkinsonian reaction in Lewy Body dementia?

Answer 5

Antipsychotics

Question 6

Name the dementia

Uneven or stepwise deterioration in cognitive function

Answer 6

Vascular

Question 7

Name the dementia

Spontaneous motor signs of Parkinson’s (rigidity/ bradykinesia/ tremor)

Answer 7

Lewy body

Question 8

Name the dementia

Evidence of CVD/ stroke

Answer 8

Vascular dementia

Question 9

Name the dementia

Early decline in social and personal conduct ( disinhibition/ tactless)

Answer 9

Frontotemporal (picks)

Question 10

Name the dementia

Decreased speech output, echolalia, perseveration, mutism

Answer 10

Front temporal

Question 11

Gradual onset with cognitive decline, other dementia are excluded

Answer 11

Alzheimer’s

Question 12

Transient disturbances of consciousness with recurrent visual hallucinations

Answer 12

Lewy body

Question 13

What is agnosia?

Answer 13

Can’t name objects

Question 14

What are the main differences between delerium and dementia?

Answer 14

Delerium is an acute onset with a fluctuating progression and there is impaired consciousness where in dementia there is no impaired consciousness
Also I delerium there is perceptual disturbance and impaired sleepwalker cylcle - not so much in dementia

Question 15

What is a perceptual disturbance?

Answer 15

Misinterpretation
Illusion
Hallucination

A scale between the 3

Question 16

What variable are tested in a cognitive function test?

Answer 16

Orientatation
Attention and concentration
Memory 
Language 
Construction

Question 17

What is a catastrophic reaction?

Answer 17

Reaction to a test where patient may get upset and refuse to go on with the test

Question 18

What is the prevalence if dementia?

What is the prevalence in those over 90?

Answer 18

1 in 85

35%

Question 19

What is the life expectancy of someone with Alzheimer’s?

Answer 19

5-8 years

Question 20

What is pseudo dementia?

Answer 20

When you have really severe depression that starts to cause dementia

Question 21

What is nominal dysphasia?

Answer 21

Can describe object but not name it

Question 22

How severe is the dementia that is sufficient to interfer with ADLs but can still live independently?

Answer 22

Mild

Question 23

Define the 4 ICD symptoms of dementia

Answer 23

Decline in memory
Decline in cognitive functions (judgement, thinking, planning)
Decline in emotional control/ behaviour
Damage to higher cortical functions (aphasia, agnosia, apraxia)

Question 24

Name some other causes of deme tail other than the obvious 4

Answer 24

``` CJD Huntingtons HIV Parkinson's Alcohol Vit B12 def ```

Question 25

What are pick cells? | What are pick bodies?

Answer 25

Ballooned neurones | Tau/ubiquitin protein bodies

Question 26

What are the three types of fronto temporal dementia?

Answer 26

- behavioural variant - progressive non fluent aphasia - semantic

Question 27

What is behavioural variant FTD?

Answer 27

Frontal love involvement predominates leading to changes in personality/ behaviour

Question 28

What is progressive non-fluent aphasia? | Which love predominates?

Answer 28

Temporal lobe leading to loss of language skills either in production or understanding

Question 29

What is fronto temporal semantic dementia?

Answer 29

Loss of semantic memnoryy - knowledge of things and concepts

Question 30

Is someone with fronto temporal dementia likely to have insight?

Answer 30

No

Question 31

What test can you use to test for perseveration?

Answer 31

Rhythmic tapping tasks - I tap once you tap twice

Question 32

Why would a CT show is frontotemporal dementia?

Answer 32

Frontotemporal atrophy | Also "knife blade atrophy"

Question 33

How does the Lewy body dementia differ with picks histology ally

Answer 33

Lewy bodies and plaques but few fibrillary tangles in Lewy body

Question 34

Where are the Lewy bodies in Parkinson's and LBD?

Answer 34

LBD - cortex, hippocampus | Parkinson's - midbrain/ substansia nigra

Question 35

What is the difference between 1) "dementia with Lewy bodies" and 2) "Parkinson's disease dementia"?

Answer 35

You have movement disorder then Cognitive impairement 1) within a year 2) more than a year later

Question 36

What are Lewy bodies?

Answer 36

Deposits of protein (alpha synuclein) within nerve cells

Question 37

Is Lewy body dementia more common in males or females?

Answer 37

Females

Question 38

What are the three core features of Lewy body dementia?

Answer 38

Fluctuating cognition Motor features of Parkinson's Visual hallucinations

Question 39

Name the dementia Recurrent falls, syncope, LOC

Answer 39

Lewy body dementia

Question 40

What are the five As of Alzheimer's?

Answer 40

``` Amnesia Aphasia Agnosia Apraxia Associated behaviours - bpsd ```

Question 41

What does bpsd stand for?

Answer 41

Behavioural and psychological symptoms in dementia

Question 42

Give examples of cortical dementia?

Answer 42

Alzheimer's Vascular Frontotemporal

Question 43

Give examples of sub cortical dementia

Answer 43

Parkinson's Huntingtons Progressive supra nuclear palsy

Question 44

What is the difference between cortical and sub cortical dementia?

Answer 44

?? Cortical often has focal cognitive impairment - memory, language, problem solving Sub cortical - psychomotor slowing

Question 45

In Alzheimer's what are present in he cortex and hippocampus?

Answer 45

Neurofibrilary tangles | Amyloid plaques

Question 46

What genetic factors predispose to late onset Alzheimer's?

Answer 46

Appoliprotein E4 (ApoE)

Question 47

What genetic factors influence early onset Alzheimer's? | What is the pattern of inheritance?

Answer 47

Prenesillin 1 and 2 Autosomal dominant

Question 48

What are the risk factors for vascular dementia?

Answer 48

Hypertension High cholesterol Diabetes Smoking

Question 49

Normal pressure hydrocephalus can cause dementia, what features does this have?

Answer 49

Patchy dementia Marked mental slowness apathy Wide based gait Urinary incontinance

Question 50

In an old person with memory problems what might you want to rule out?

Answer 50

Depression - severe depression can cause memory loss

Question 51

Name some anticholinesterases

Answer 51

Donepezil, rivistigmine, galantamine

Question 52

When should anticholinesterases be used?

Answer 52

In mild to moderate Alzheimer's/ Lewy body

Question 53

What is memantine?

Answer 53

Modulates glutamine transmission

Question 54

What is memantine used for?

Answer 54

Moderate to severe Alzheimer's

Question 55

What has a worse prognosis Alzheimer's or vascular?

Answer 55

Vascular

Question 56

What is the average length of delerium?

Answer 56

7days

Question 57

What drugs can be used in Alzheimer's dementia?

Answer 57

Acetylcholinesterase inhibitors | Memantine

Question 58

How does memantine work?

Answer 58

Glutamate receptor antagonist

Question 59

Name some ACh esterase inhibitors

Answer 59

Donepezil, galantamine, rivistigmine

Question 60

What is there a risk of if a person is on both Donepezil and an antipsychotic?

Answer 60

Neuroleptic malignant syndrome

Question 61

What factors assessed when assessing cognition?

Answer 61

``` Orientation (time, place, person) Concentration/ attention Memory Language Construction ```

Question 62

What are the 5 A's of Alzheimer's?

Answer 62

``` Amnesia Apraxia Aphasia Agnosia Associated behaviours / psych conditions ```

Question 63

What groups of people is Alzheimer's screened for?

Answer 63

Down's syndrome Post stroke Parkinson's disease