Psychiatry - QuesMed Flashcards
(10 cards)
What is the definition of dementia?
According to ICD-10, dementia is a syndrome, usually of chronic or progressive nature, which involves impairment of multiple higher cortical functions, such as memory, thinking, orientation, comprehension and language.
What is Alzheimer’s disease?
The most common cause of dementia is Alzheimer’s disease, a chronic and progressive form of dementia, which is caused by characteristic neuropathological features such as amyloid plaques and tau proteins. Alzheimer’s disease is caused by a build up of amyloid protein deposits around brain cells and tau protein tangles within brain cells.
What is Lewy body dementia?
In Lewy Body Dementia, abnormal protein deposits called Lewy Bodies cause cognitive decline associated with parkinsonism (rigidity, tremor, bradykinesia).
What is frontotemporal dementia?
Fronto-temporal dementia presents with cognitive impairment, personality change and disinbition, in keeping with the frontal area of the brain which is affected. Atrophy of the frontal and temporal lobes is seen.
What is vascular dementia?
Vascular dementia, a result of multiple infarcts in the brain tends to present with sudden onset cognitive decline and stepwise deterioration in someone with previous cardiovascular illness or events, as a result of the developing infarcts.
What is Wernicke’s encephalopathy?
Wernicke’s encephalopathy presents with the classic tetrad of ataxia, opthalmoplegia, nystagmus and acute confusional state and is associated with lesions in the mamillary bodies.
What are the CT findings of normal pressure hydrocephalus?
Enlarged ventricles and absent sulci. The sulci are absent because the enlarged ventricles put pressure on them, allowing for overall pressure to be normal, despite the CSF increase.
With which type of dementia is there an association with in Down’s syndrome?
Alzheimer’s disease is caused by an accumulation of amyoid plaques, and the tau protein is also implicated. Down Syndrome is caused by Trisomy 21, and the amyloid precursor protein is found on chromosome 21. The extra copy of APP leads to early onset beta-amyloid plaques.
When there is contraindications to drugs in Alzheimer’s disease what therapy can be used?
Cognitive stimulation therapy
The fact this patient has evidence of QT prolongation makes the prescription of anti-cholinesterase inhibitors unsafe. Also, they might make his diarrhoea and urge incontinence worse. The learning point here is that you should always check a patient’s ECG before starting anti-cholinesterase inhibitors.
Contra-indications include prolonged QT, second or third degree heart block in an unpaced patient and sinus bradycardia <50 bpm.
Along with Cognitive stimulation and of equal consideration are the “Bio-psycho-social” aspects of holistic management for a patient which may include a carer referral, information giving, support groups, psychoeducation, and Advance Care Planning.
What is transient global amnesia?
Transient global amnesia is a neurological condition characterised by a temporary but total disruption of both short and long term memory. Other cognitive functions are preserved. It can present with patients being found wandering the street far away from their home. The episode may last for several hours before spontaneously resolving. The pathophysiology is poorly understood, it may be a form of seizure or migraine-like phenomenon or due to impaired blood flow in the brain. Patients normally make a full recovery and the phenomenon is unlikely to recur.
