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MD4001 Pathology > The clinical aspects of dementia and its effects on patients > Flashcards

The clinical aspects of dementia and its effects on patients Flashcards

1
Q

what are the features of dementia

A

intellectual function and memory loss
deterioration in ADL
social behaviour change

a syndrome, not a specific disease
there is no single diagnostic test or biomarker
no treatment to alter the course of disease

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2
Q

what are the neuropsychological features of dementia

A

amnesia
aphasia
agnosia
apraxia

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3
Q

what are the neuropsychiatric features of dementia

A

behavioural and psychological symptoms

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4
Q

what is the function of the frontal lobes

A

sequencing and fluency

emotional expression, problem solving, memory, language, judgment, and sexual behavior. personality and communication.

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5
Q

what is the function of the temporal lobes

A

language, memory, speech and auditory

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6
Q

how do you test function in the temporal lobes

A

address test, object recall, serial 7s

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7
Q

how do you test function in the frontal lobes

A

Luria hand sequencing task

Verbal fluency 1 minute words F,A, S, animals

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8
Q

what is the function of the parietal lobes

A

spatial awareness, language, integration of sensory information

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9
Q

how do you test function in the parietal lobes

A

clock face
name objects
draw a cube
agnosia (inability to recognise things)

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10
Q

what are the features of the addenbrookes cognitive exam

A 
20 mins
score out of 100
reliable
multidomain 
available on iPad
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11
Q

how long does it take for the patient to notice symptoms after the beginning of pathological changes to the brain

A

15-30 years

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12
Q

what is T1 to T4

A

1- earliest possible diagnosis if we develop biomarker tests
2- earliest possible diagnosis using current technology
3- timely diagnosis
4- late stage diagnosis

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13
Q

what is mild cognitive impairment

A

subjective memory impairment not meeting dementia diagnostic criteria and no impact on activities of daily living
may develop into dementia but recovery is also possible

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14
Q

how can early diagnosis of alzheimers be useful

A

detection and treatment slow rate of disease progression at a preclinical stage and will have a greater disease modifying effect than targeting patients with MCI

could be with biomarkers of neuroimaging

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15
Q

what is perfusion SPECT

A

single photon emission computed tomography

images variations in regional cerebral blood flow which displays characteristic abnormalities in early AD

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16
Q

what is FDG-PET

A

fluoro deoxyglucose positron emission tomography

uptake of FDG proportional to cerebral glucose metabolism

17
Q

what is amyloid imaging

A

beta amyloid is a normal product of cell metabolism

overproduction and insufficient clearance of beta amyloid is responsible for accumulation of plaques of beta amyloid

18
Q

what is Pittsburgh compound B positron emission tomography

A

binds to beta amyloid allowing imaging of beta amyloid burden

good for early detection
can detect response to treatments

19
Q

what CSF markers are being investigated for diagnosis and management of Alzheimer’s

A

amyloid beta
total tau
phosphorylated tau

not currently useful

20
Q

what drugs are currently available for mild and moderate Alzheimer’s

A

donepezil
galatamine
rivastigmine

21
Q

what drug is used to manage moderate and severe alzeimers

A

memantine

22
Q

what symptoms are included in BPSD

A 
hallucinations 
delusions
misidentifications
depression 
anxiety 
apathy elation 
disinhibition 
irritability 
aggression 
agitation 
sleep disturbances
stereotypies
hyperorality 
eating disturbance
hypersexuality

likely to be one of the most problematic aspects for patients and carers

23
Q

What are the features of DLB

A 
cognitive decline
fluctuations in attention and alertness
visual hallucinations
motor features of parkinsons 
transient LOC
24
Q

what is young onset dementia

A

30-64 years old

25
Q

what are the features of frontotemporal dementia

A 
behavioural disorder
loss of personal and social awareness
disinhibition 
stereotyped behaviour
mood disorder
speech disorder
before 65 
positive family history 
reduced empathy 
impulsivity 
poor self care 
preserved memory
26
Q

what are the features of vascular dementia

A
  • problems with planning or organising, making decisions or solving problems
  • difficulties following a series of steps
  • slower speed of thought
  • problems concentrating, short periods of sudden confusion.
  • memory
  • language - eg speech may become less fluent
  • visuospatial skills - problems perceiving objects in three dimensions.
27
Q

what are the features of a dementia assessment

A

patient interview
cognitive examination
interview with relative or carer
clinical investigations- blood, biochemical, radiological
specialist assesments (psychometric assessment, occupational therapy, speech and language, neurological, geriatrics)
diagnostic confirmation

MD4001 Pathology (23 decks)

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