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Psychiatry > Neurobiology of cognition and dementia > Flashcards

Neurobiology of cognition and dementia Flashcards

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1
Q

What is Broca’s aphasia also known as

A

expressive aphasia

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2
Q

Broca’s aphasia has good/poor comprehension and good/poor speech

A

good comprehension

poor speech

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3
Q

What is Wernicke’s aphasia also known as

A

receptive aphasia

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4
Q

Wernicke’s aphasia has good/poor comprehension and good/poor speech

A

poor comprehension

good speech

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5
Q

define dementia

A

progressive, irreversible, global cognitive decline

disruption to higher cortical function in clear consciousness

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6
Q

can you get dementia after a large stroke

A

no, because onset of dementia is progressive/chronic

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7
Q

which Brodmann area is the primary motor cortex

A

4

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8
Q

which brain structure is important for incorporating short into long term memory

A

hippocampus

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9
Q

what is damaged in Alzheimer’s disease

A

nucleus basalis of Meynert in medial temporal lobe

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10
Q

which pathways are disrupted in Alzheimers

A

ACh

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11
Q

molecular features of Alzheimers

A

extracellular amyloid plaques

intracellular neurofibrillary tangles (tau)

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12
Q

symptoms of Alzheimers

A 
short term memory loss 
dysphasia
dyspraxia 
agnosia 
poor adaptability 
psychosis 
dysphagia - late stage
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13
Q

management of Alzheimer’s disease

A

acetylcholinesterase inhbitors eg

donepezil, rivastigmine, galantamine

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14
Q

what is memantine

A

low affinity, voltage dependent, non-competitive NMDA antagonists

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15
Q

what is vascular dementia

A

stepwise progression after accumulative small infarcts

overlaps with Alzheimers

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16
Q

features of vascular dementia

A

affects white matter
dysphasia, dyscalculia
mood symptoms
focal neurological signs

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17
Q

what is the damage in Lewy Body Dementia DLB

A

a-synuclein and ubiquitin at higher quantities in the brain
loss of dopaminergic neurons in substantia nigra
presence of lewy bodies
loss of ACh in nucleus basalis of meynert

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18
Q

features of lewy body dementia

A 
fluctuating 
visual hallucinations 
parkinsonism 
autonomic instability 
visuospatial problems 
REM behavioural disorder
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19
Q

which drugs should be avoided in lewy body dementia

A

dopamine agonists eg sinemet

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20
Q

management of lewy body dementia

A

acetylcholinesterase inhibitors

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21
Q

timing of dementia in Parkinson’s disease

A

dementia within 1 year of symptoms = DLB

dementia after 1 year of symptoms = parkinson’s disease dementia

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22
Q

damage in frontotemporal lobe dementia

A

atrophy of frontal and temporal lobes with corresponding reduction in activity
gliosis
abnormal proteins

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23
Q

symptoms of FTD

A

social disinhibition
early onset
personality changes
apathy

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24
Q

what are the types of FTD

A

behavioural
progressive non-fluent
semantic

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25
cause of Wernicke's encephalopathy
thiamine/vit B1 deficiency
26
wernicke's encephalopathy triad of symptoms
confusion ataxia ophthalmoplegia
27
symptoms of wernicke's encephalopathy
``` confusion ataxia ophthalmoplegia visual and hearing impairments reduced consciousness hypothermia lactic acidosis circulatory changes ```
28
what should be given in wernicke's encephalopathy to prevent progression to Korsakoff's
IV pabrinex (vitamins)
29
what is the damage in Korsakoff's syndrome
damage to mamillary bodies
30
symptoms of Korsakoff's
confabulation anterograde amnesia telescoping of events
31
is alcohol induced brain damage a type of dementia
no
32
consequences of alcohol induced brain damage
Wernicke-Korsakoff myelin sheath degradation neuroinflammation falls
33
differentials of dementia
``` delirium depression --> pseudodementia deafness dysphasia late onset Schizophrenia subdural haematoma tumours infection ```
34
duration of sensory memory
<1 sec
35
duration of short term memory
<1 min
36
duration of long term memory
lifetime
37
explicit memory is conscious/unconscious
conscious
38
implicit memory is conscious/unconscious
unconscious
39
difference between episodic memory and semantic memory
``` episodic = personal events and experiences semantic = facts, concepts, knowledge ```
40
anterograde amnesia
difficulty in acquiring new information since onset of illness
41
retrograde amnesia
difficulty in acquiring new information prior to onset of illness
42
defining factors of dementia
progressive ie >6 months global cognitive decline disturbance of higher cortical functions clear consciousness
43
what are useful questions to ask in a dementia history
``` day to day life affected problems in kitchen difficulty with technology news/newspaper driving hobbies ```
44
what does cognitive screening assses
``` memory attention + concentration executive functioning visuo-spatial functioning language ```
45
what is the 4AT and what are its elements
``` rapid assessment for delirium Alertness AMT4 Attention Acute ```
46
which screening test should be used initially in the case of dementia
MMSE
47
advantages and disadvantages of MMSE
Adv: quick, different languages, pen and paper only Disadv: poor examination of executive functioning, copyrighted
48
MMSE of what score supports and excludes dementia
>27/30 - excludes | <24/30 - supports
49
when is the 6-CIT used
in non-specialist settings | bedside test
50
what is the GPCOG
6 questions asked in the GP/community setting
51
scoring of GPCOG
9 = normal 5-8 0-4 = poor
52
what is the clock drawing test
assesses executive function, visuospatial ability
53
what is the MoCA
Montreal Cognitive Assessment rapid screening instrument for mild cognitive dysfunction freely available
54
what is ACE
addenbrooke's cognitive assessment | scored out of 100 and assesses 5 domains
55
what is a normal score in ACE
>84/100
56
what is neuropsychological assessment
determines abnormal intellectual/behavioural decline and whether it is relating to CNS disease
57
what is CMHT
community mental health team
58
what is post diagnostic support for dementia
for patient + family/friends after diagnosis including counselling, financial advice/legalities power of attorney ...
59
what cognitive testing is available
ACEIII MoCA frontal assessment battery FAB detailed neuropsychological testing
60
what is the shortIQCODE used for
taking a collateral history
61
who carries out a cognitive performance test
OT
62
what are reversible causes of cognitive impairment
``` VINDICATE delirium alcohol drugs endocrine depression brain lesion infections ```
63
define mild cognitive impairment
noticeable cognitive impairment with little deterioration in functioning
64
ACEIII and MoCA scores for mild cognitive impairment
ACEIII 75-90/100 | MoCA 24-26/30
65
what is subjective cognitive impairment
patient feels cognitively impaired but the tests are all normal
66
criteria for DLB
``` visual hallucinations fluctuating parkinsonism REM behavioural disorder positive DAT scan ```
67
can you diagnose dementia from a scan
NO
68
role of CT scan
excludes lesions, bleeds, stroke, vascular changes, structural changes
69
indication for MRI
young fast progression atypical features
70
what is a SPECT scan most useful for
FTD | sometimes to clarify Alzheimer's
71
when is a DAT scan used
suspected DLB/DPD when there arent enough supporting features
72
what do acetylcholinesterase inhibitors do
increase ACh at synaptic cleft
73
pharmacological management of Alzheimer's
donepezil rivastigmine glanatamine
74
pharmacological management of DLB/DPD
rivastigmine
75
side effects of AChE inhibitors
``` nausea, diarrhoea headaches muscle cramps bradycardia worsen asthma/COPD ```
76
contraindications to AChE inhibitors
active PUD | asthma/COPD
77
what is memantine
NMDA antagonist to slow cognitive decline in Alzheimer's | started in moderate dementia
78
what does memantine prevent
BPSD | behavioural and psychological symptoms of dementia
79
side effects of memantine
``` hypertension sedation dizziness headache constipation ```
80
somebody with a dementia diagnosis must report to the DVLA, true or false
true
81
what form is filled in with regards to driving
CG1 form
82
what is the Rockwood Driving Battery Test
assesses different aspects of driving
83
what are features of BPSD
``` hallucinations delusions insomnia anxiety depression aggression disinhibition agitation ```

Psychiatry (27 decks)

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