TBL 2- Dementia (Pre-reading) Flashcards Preview

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Flashcards in TBL 2- Dementia (Pre-reading) Deck (10):

What is the ICD-10 criteria for Dementia?

Syndrome due to brain disease
-chronic or progressive
-disturbance of higher cortical functions:
1. Memory
2. Thinking
3. Orientation
4. Comprehension
5. Calculation
6. Learning capacity
7. Language
8. Judgement
-Consciousness is not clouded
Cognitive function often preceded by deterioration in emotional control, social behaviour or motivation


What are the common neuropathological findings in the brain of someone wit Alzheimer's dementia?

Amyloid plaques- outside cell, where the fragments are left after secretases snip APP, and disintegrated dendrites exist
Neurofibrillary tangles- inside cell


Where is the main source of ACh for the cortex in the brain?

The Nucleus Basalis of Meynert in the basal forebrain.
It is one of the first areas of the brain affected in AD.


What three cholinesterase inhibitors are in use for alzheimers?

1. Donepezil
2. Rivastigmine- AD + Dementia with Lewy Bodies
3. Galantamine

Slow cognitive decline by increasing cholinergic transmission.
Licenced for mild-moderate alzheimers.


What are common side effects of cholinesterase inhibitors?

GI upset
Sleep disturbance
Bradycardia - increased ACh stimulates the vagus systeme


What is the license and mechanism of action of Memantine?

Moderate-severe Alzheimers
MoA: blocks NMDA-type glutamate receptors

Theory: neurons are damaged by glutmate over-activation
(Glutamate is main excitatory NT in the brain)


What are the common side effects of memantine?



What is the Hachinski Ischaemic Score?

It is a quick and easy test for vascular dementia ddx AD
Score =4 indicates Alzheimer's
Score >/=7 indicates Vascular Dementia

Abrupt onset 2
Stepwise deterioration 1
Fluctuating course 2
Nocturnal confusion 1
Preservation of personality 1
Depression 1
Somatic complaints 1
Emotional incontinence 1
History of hypertension 1
History of stroke 2
Associated atherosclerosis 1
Focal neurological symptoms 2
Focal neurological signs 2


What clinical criteria differentiate Lewy Body Dementia and Dementia in Parkinson's Disease?

DLB- Cognitive impairment precedes or coincides with movement disorder
DPD- Movement disorder is present FIRST for at least a YEAR prior to onset of cognitive impairment.


What are the features of probable dementia with Lewy Bodies?

2 of 3:
1. Flux. cognition with variation in attention and alertness
2. Recurrent visual hallucinations- well formed and detailed often
3. Spontaneous features of parkinsonism

OR 1 of the above + 1 of:
1. PEM sleep behaviour disorder
2. Severe neuroleptic sensitivity
3. Low dopamine transporter uptake in basal ganglia dem. by SPECT or PET imaging.