The clinical aspects of dementia and its effects on patients Flashcards Preview

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Flashcards in The clinical aspects of dementia and its effects on patients Deck (27):
1

what are the features of dementia

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

2

what are the neuropsychological features of dementia

amnesia
aphasia
agnosia
apraxia

3

what are the neuropsychiatric features of dementia

behavioural and psychological symptoms

4

what is the function of the frontal lobes

sequencing and fluency

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

5

what is the function of the temporal lobes

language, memory, speech and auditory

6

how do you test function in the temporal lobes

address test, object recall, serial 7s

7

how do you test function in the frontal lobes

Luria hand sequencing task
Verbal fluency 1 minute words F,A, S, animals

8

what is the function of the parietal lobes

spatial awareness, language, integration of sensory information

9

how do you test function in the parietal lobes

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

10

what are the features of the addenbrookes cognitive exam

20 mins
score out of 100
reliable
multidomain
available on iPad

11

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

15-30 years

12

what is T1 to T4

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

13

what is mild cognitive impairment

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

14

how can early diagnosis of alzheimers be useful

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

15

what is perfusion SPECT

single photon emission computed tomography

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

16

what is FDG-PET

fluoro deoxyglucose positron emission tomography

uptake of FDG proportional to cerebral glucose metabolism

17

what is amyloid imaging

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

what is Pittsburgh compound B positron emission tomography

binds to beta amyloid allowing imaging of beta amyloid burden

good for early detection
can detect response to treatments

19

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

amyloid beta
total tau
phosphorylated tau

not currently useful

20

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

donepezil
galatamine
rivastigmine

21

what drug is used to manage moderate and severe alzeimers

memantine

22

what symptoms are included in BPSD

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

What are the features of DLB

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

24

what is young onset dementia

30-64 years old

25

what are the features of frontotemporal dementia

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

what are the features of vascular dementia


•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

what are the features of a dementia assessment

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