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Memory problems Flashcards

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1
Q

What is anterograde amnesia?

What is retrograde amnesia?

A

Anterograde amnesia; difficulty in remembering new information since the onset of the illness

Retrograde amnesia; difficulty in remembering past information from prior to the onset of the illness

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2
Q

List some of the reversible causes of memory loss

A

Depressive pseudodementia

Wernicke-Korsakoff syndrome

Normal pressure hydrocephalus

Delirium

PTSD

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3
Q

When would you do MoCA and when would you do an Addenbrookes?

A

MoCA is quicker so done by a GP or if the patient is too anxious or unable to complete a longer test

Addenbrookes is the test commonly done in old age psychiatry

*Both look at memory and cognitive function

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4
Q

What is dementia?

A

Progressive global cognitive decline which is irreversible

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5
Q

What are the 4 primary dementias?

A

Alzheimer’s

Lewy body dementia

FTD

Huntington’s disease

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6
Q

What are examples of secondary dementias?

A

Vascular dementia

Infection

Trauma

Metabolic

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7
Q

What are some of the risk factors for dementia?

A

Age
Alcohol
Diet
Concussions

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8
Q

What cognitive tests can be done to assess a patient with dementia?

A

MMSE
MoCA
Addenbrooke’s

Frontal assessment battery (FAB)

Neuropsychological testing

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9
Q

Why should bloods be part of the routine investigation for dementia?

A

To rule out other causes of the presentation such as; syphilis, thyroid problems and vitamin deficiencies

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10
Q

What is the best imaging investigation to do in a patient with suspected dementia?

A

CT

Less distressing for a patient than MRI an cheaper

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11
Q

When should an MRI be done in a patient presenting with memory problems?

A

Young patients, atypical presentation, unclear diagnoses

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12
Q

What medications can be used in the management of Alzheimer’s disease?

A

Acetylcholinesterase inhibitors

Memantine

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13
Q

What are the contraindications to the use of acetylcholinesterase inhibitors in patients with alzheimer’s disease?

A

Asthma and COPD

Causes bradycardia - so must check pulse

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14
Q

When should a patient be started on memantine?

A

In moderate cases of Alzheimer’s or when acetylcholinesterase inhibitors are contraindicated or have not worked for the patient

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15
Q

What is mild cognitive impairment?

A

Noticeable cognitive impairment with little deterioration in function

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16
Q

What is the most common form of dementia in the elderly?

A

Alzheimer’s

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17
Q

What condition is associated with an increased risk of developing Alzheimer’s later in life?

A

Down’s syndrome

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18
Q

Which is affected first in patients with alzheimer’s; memory or behaviour?

A

Memory first, behaviour later

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19
Q

Which type of memory is affected first in patients with Alzheimer’s?

Study These Flashcards
A

Short - term

atrophy of the hippocampus

20
Q

What is agnosia, a symptom of Alzheimer’s?

Study These Flashcards
A

Difficulty in recognising familiar faces and objects

21
Q

What is anosognosia, a feature of Alzheimer’s disease?

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A

Lack of insight

22
Q

Visuo-spatial issues can occur in Alzheimer’s if what part of the brain is atrophied?

Study These Flashcards
A

Posterior cortical

23
Q

What is capgras syndrome?

Study These Flashcards
A

A type of delusion which occurs in Alzheimer’s

The patient has the irrational belief that someone they know or recognise has been replaced by an imposter

24
Q

What are fregoli delusions?

Study These Flashcards
A

A type of delusion which occurs in Alzheimer’s

Irrational belief that multiple people are in fact the same person who changes appearance or is in disguise

25
What causes Alzheimer's?
Accumulation of the degradation products of the amyloid precursor protein
26
Describe the macroscopic pathology in Alzheimer's disease
Widening of sulci and narrowing of gyri Compensatory dilatation of the ventricles
27
What are some of the microscopic features of Alzheimer's dementia?
Neuronal loss with associated astrocyte proliferation Neuritic plaques Amyloid angiopathy Neurofibrillary tangles
28
What is the 2nd most common cause of dementia?
Vascular dementia (multi-infarct dementia)
29
Which is affected first in vascular dementia; behaviour or memory?
Behaviour is affected first, memory is affected later
30
Describe the progress of vascular dementia
Sudden onset with stepwise progression
31
What would you be likely to see on CT/MRI in a patient with vascular dementia?
Multiple lacunar infarcts
32
What is the 3rd most common form of dementia?
Lewy Body Dementia
33
Which type of dementia is one of the Parkinson + syndromes?
Lewy Body Dementia
34
Describe the progress of Lewy Body dementia
Fluctuating levels of attention and cognition on a day-to-day basis
35
Lewy Body dementia can be similar in its presentation to delirium. What things could you ask about to differentiate the two?
Parkinsonism symptoms History of falls
36
What are some of the clinical signs and symptoms of Lewy Body Dementia?
Visual hallucinations REM sleep disorders Parkinsonism and falls Dementia
37
What drug should not be given to patients with Lewy Body dementia?
Haloperidol
38
How can Parkinson's dementia be differentiated from Lewy Body dementia?
Lewy body dementia; parkinsonism and dementia occur at roughly the same, or if parkinsonism appears first, symptoms must have been present for <1 year before the onset of dementia Parkinson's dementia; parkinson's first, dementia years later
39
What is the function of the frontal lobe of the brain? What is the function of the temporal lobe of the brain?
Frontal; Structured thinking and behaviour Temporal; Making memories
40
Describe the progression in FTD
Rapid progression
41
What part of the brain is the first to be affected in patients with FTD?
Frontal lobe (behaviour first) These patients can often therefore perform well on cognitive testing
42
What 3 syndromes can occur in FTD?
Behavioural Semantic Primary progressive aphasia
43
Describe behavioural FTD
Personality and behaviour changes, disinhibition, impulsivity, changes in eating habits and loss of social skills
44
Describe semantic FTD
Speech and communication problems Patient may become mute with time
45
Describe primary progressive aphasia FTD
Effortful non-fluent speech with articulation errors
46
What are the triad of symptoms in Huntington's disease?
Triad of emotional, cognitive and motor disturbance
47
Where are the most common areas of missed pain and distress in patients with dementia?
Teeth, back and feet

PSYCHIATRY (11 decks)

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