Memory problems

Question 1

What is memory?

Answer 1

Memory is essential to normal human functioning

Without memory we could not recognise anyone or anything familiar.

We would not be able to talk, read, or write because we could not remember anything about language.

We wouldn’t be able to learn from experiences

Question 2

3 main types of human memory?

Answer 2

Sensory memory (< 1 sec)

Short-term memory (< 1 min)

Long-term memory (lifetime)

Question 3

Types of long-term memory?

Answer 3

Explicit memory (conscious)

Implicit memory (unconscious)

Question 4

What is implicit memory?

Answer 4

Revealed when performance on a task is facilitated in the absence of conscious recollection e.g. Tying shoes, riding a bike.

Phrased as being something that is “second nature”.

Question 5

What is explicit memory?

Answer 5

Revealed when performance on a task requires conscious recollection of past experiences. E.g. Dates of a historical event, who came to dinner last night

Question 6

What are the 2 types of memory loss?

Answer 6

Retrograde amnesia

Anterograde amnesia

Question 7

What is retrograde amnesia?

Answer 7

Difficulty in remembering information prior to onset of injury or illness.

So person can remember new events but not events prior to incident.

Question 8

What is anterograde amnesia?

Answer 8

Difficulty in acquiring new material and remembering events since the onset of the illness or injury.

Can be short term e.g. potentially after a head injury

Or longer term and extensive (korsakoffs and later stages of Alzheimers)

Question 9

What are some typical reports of memory problems?

Answer 9

Forgetting a message
Losing track of a conversation
Forgetting to do things
Inability to navigate in familiar places
Increased misplacing of things
Struggling to remember names

Question 10

Dementia vs delirium vs depression onset?

Answer 10

Dementia = insidious

Delirium = acute

Depression = gradual

Question 11

Dementia vs delirium vs depression duration?

Answer 11

Dementia= Months/Years

Delirium = Hours/Days/ Weeks/Months

Depression = Weeks/Months

Question 12

Dementia vs delirium vs depression course?

Answer 12

Dementia = Stable, progressive, step – wise

Delirium = Fluctuating

Depression = Diurnal (during day)

Question 13

Dementia vs delirium vs depression alertness?

Answer 13

Dementia = Normal

Delirium = Impaired

Depression = Normal

Question 14

Dementia vs delirium vs depression orientation?

Answer 14

Dementia = Normal or impaired to time/place

Delirium = Impaired

Depression = Normal

Question 15

Dementia vs delirium vs depression memory?

Answer 15

Dementia = Recent & remote impaired

Delirium = Recent impaired

Depression = Remote intact,
concentration is poor

Question 16

Dementia vs delirium vs depression thinking?

Answer 16

Dementia = Slowed, reduced interest

Delirium = Can be paranoid & bizarre

Depression = Slow & preoccupied

Question 17

Dementia vs delirium vs depression perception?

Answer 17

Dementia = Hallucinations (in 30 – 40 %)

Delirium = Visual and auditory hallucinations common

Depression = Mood congruent auditory hallucinations

Question 18

Dementia vs delirium vs depression emotions?

Answer 18

Dementia = Shallow, labile, irritable

Delirium = Irritable, aggressive & fearful

Depression = Flat, unresponsive and sad

Question 19

Dementia vs delirium vs depression sleep?

Answer 19

Dementia = Nocturnal wandering & confusion

Delirium = Nocturnal confusion

Depression = Early morning wakening

Question 20

Why is assessment of cognition necessary?

Answer 20

To evaluate the individual’s cognitive functioning
To identify the underlying pathological processes
To aid the diagnosis process
To inform treatment
To assess capacity

Question 21

What is a corroborative history?

Answer 21

A history taken from 2 sources regarding the patient, in this case a history of the patient is taken from the staff and patients family.

Question 22

What is 4AT?

Answer 22

A rapid clinical test for the detection of delirium

Aimed at detecting moderate-severe cognitive impairment

Question 23

Components of 4AT?

Answer 23

Alertness (normal/mild sleepiness/clearly abnormal)

AMT-4 (age, DOB, place, current year)

Attention (months backwards)

Acute or fluctuating course

Question 24

What is a mini mental state examination (mmse) and how is it scored?

Answer 24

A Mini-Mental State Examination (MMSE) is a set of 11 questions that doctors and other healthcare professionals commonly use to check for cognitive impairment (problems with thinking, communication, understanding and memory).

The maximum score for the MMSE is 30. A score of 25 or higher is classed as normal. If the score is below 24, the result is usually considered to be abnormal, indicating possible cognitive impairment.

Question 25

Addenbrookes cognitive examination III is scored out of 100 with 5 domains. true/false?

Answer 25

true

Question 26

What are the 5 domains of the ACE III?

Answer 26

Orientation and attention
Memory
Fluency
Language
Visuospatial functioning