Memory Loss

Question 1

What is Dementia?

Answer 1

Cognitive impairment which is progressive, multi domain affects life and due to brain disease occurring in over 40s

Question 2

cognitive domains?

Answer 2

memory
language
visuospatial
executive
social behavioural
psychiatric

Question 3

Alzheimer’s disease features?

Answer 3

beta amyloid aggregation
then tau aggregration (neurofibrillary tangles)
loss of function, loss of cells
amyloid angiopathy

Question 4

what is TDP-43?

Answer 4

DNA binding protein

Question 5

FTLD and prion cause

Answer 5

rapid brain shrinkage

Question 6

visuospatial alone?

Answer 6

posterior cortical atrophy

Question 7

FTLD often includes?

Answer 7

tau TDP43 FUS

Question 8

parkinsons disease includes which protein?

Answer 8

alpha synuclein

Question 9

fixed cognitive impairment?

Answer 9

ADHD, ASD, learning disability, perinatal hypoxia, meningitis, head injury, stroke

Question 10

vascular dementia?

Answer 10

slowness and efficiency of thought, not memory or language

Question 11

slowable causes of cognitive impairment?

Answer 11

hydrocephalus normal pressure
b12 deficiency
cerebrovascular damage
alcohol damage

Question 12

which ion causes cognitive impairment?

Answer 12

hyponatraemia

Question 13

mild cognitive impairment?

Answer 13

only one domain typically memory
or doesnt affect daily life

Question 14

Benefits of MRI?

Answer 14

no radiation
better imaging: grey matter - cortical thickness, atrophy
white matter- vascular lesions

Question 15

fazekas scale looks at?

Answer 15

white matter change, vessel disease

Question 16

diagnosis of alzheimers?

Answer 16

markers of amyloid deposition and neurodegenerative changes

Question 17

what does FDG-PET look at in Alzheimers?

Answer 17

hypometabolism- temporoparietal usually drop out more

Question 18

frontal lobe damage can cause?

Answer 18

disinhibition

Question 19

semantic memory loss?

Answer 19

know what things are and facts , temporal lobe left

Question 20

Lewy body dementia features?

Answer 20

parkinsonian features, hallucinations

Question 21

what imaging can you do for lewy body dementia?

Answer 21

dopaminergic SPECT, due to reduced dopamine uptake

Question 22

how to image Tau?

Answer 22

PET radiolabel tau with braak staging

Question 23

scanning for Alzheimers?

Answer 23

neuroinflammatory scanning
high resolution MRI- subfield-level
diffusion tensor imaging and tractogrpahy- meaure white matter tract

Question 24

cognitive reserve?

Answer 24

adaptability of cognitive processes underpinning differential susceptibility to brain aging or disease

Question 25

brain reserve?

Answer 25

neurons and synapses

Question 26

risk factor for Alzheimers?

Answer 26

apoE e4 allele

Question 27

what is associated with slower cognitive decline

Answer 27

higher brain BDNF gene expression

Question 28

what increases the anticoagulant effect of warfarin and by which mechanism?

Answer 28

metronidazole, CYP450 inhibition

Question 29

what would reduce exposure to theophylline and mechanism?

Answer 29

rifampicin, inducer of cytochrome P450

Question 30

which are the cytochrome p450 inhibitors?

Answer 30

amiodarone ciprofloxacin erythromycin clarithromycin metronidazole fluconazole isoniazid alcohol grapefruit juice

Question 31

cytochrome p450 inducers?

Answer 31

increase drug metabolism and reduce exposure CRAP carbamazepine rifampicin alcohol chronic phenytoin

Question 32

colchicine side effect?

Answer 32

b

Question 33

etoricoxib is a?

Answer 33

cox 2 inhibitor

Question 34

advantage of cox 2 inhibitor?

Answer 34

selective, so less likely to cause gastric side effects

Question 35

NSAIDs cause?

Answer 35

increase sodium reabsorption and hence water too

Question 36

cox 2 inhibitors have a risk of?

Answer 36

clotting

Question 37

amiodarone causes?

Answer 37

inhibits efflux of digoxin by p glycoprotein pump and therefore reduced its clearance

Question 38

common side effects of amiodarone?

Answer 38

thyroid- hypo/hyper grey skin- shield from light, photosensitivity sleep disorders hepatic corneal deposits/ optic neuropathy, blurred vision pulmonary toxicity

Question 39

loading dose for amiodarone?

Answer 39

high half life and strongly protein bound (albumin) so give lots to block of all proteins

Question 40

how many half lives to achieve a steady state?

Answer 40

5

Question 41

for sepsis gentamicin is given?

Answer 41

1 daily, infective endocarditis 2 daily

Question 42

why is weight important for gentamicin?

Answer 42

water soluble drug, always dose on a lean body weight

Question 43

significant drug interaction with gentamicin?

Answer 43

bumetanide- loop diuretic ototoxic side effects increases risk of nephrotoxicity

Question 44

scoring system for stroke risk?

Answer 44

CHA2DSVAS

Question 45

how does apixaban work?

Answer 45

factor 10 inhibitor

Question 46

in AKI metformin needs to be stopped because of?

Answer 46

acidosis