WK8 tutorial

Question 1

What is MoCA?

Answer 1

Cognitive assessment
* 26/30 is normal
* anything under is impairment

Question 2

What are the 3 levels of impairments in clinical diagnosis of neurodegen. disease?

Answer 2

1. SCD
2. MCI
3. Dementia

Question 3

What can shuffling gait suggest in a physical exam?

Answer 3

Vascular Dementia, Lewy, PD

Question 4

What can restricted upgaze suggest in a physical exam?

Answer 4

PSP

Question 5

What can increased tone suggest in a physical exam?

Answer 5

Vascular dementia, Lewy, PD

Question 6

What are some non-specific factors to look out for in clinical diagnosis?

Answer 6

1. Weight loss
2. Depression
3. Active hallucinations/delusions
4. Comorbidities - heart failure, COPD,

Question 7

What is Vascular Dementia?

Answer 7

When conditions such as blood clots restrict blood flow to brain

Question 8

What are the risk factors for vascular dementia?

Answer 8

1. Hypertensions
2. Elevated chol
3. Stroke

Question 9

Symptoms of vascular dementia

Answer 9

Clinically present same as AD, but early impairment in judgement and exec. function

Question 10

What is behavioural disinhibition

Answer 10

Lack of control on behaviour
* Socially innapropriate
* Loss of manners/decorum
* Impulsivity

Question 11

What is the neuropathology of Lewy body dementia?

Answer 11

alpha synuclein accumulation

Question 12

Symptoms required for Lewy body

Answer 12

Memory impairment with +⅔ more features:
1. Visual hallucinations
2. Fluctuating cognition
3. Parkinsonism

Question 13

SCD

Answer 13

Subjective cognitive decline
* Patient has concerns
* Everyday function is preserved
* MoCA normal

Question 14

MCI

Answer 14

Mild cognitive impairment
* Memory tests indicate impairment
* Everyday function still preserved

Question 15

Dementia (classification of impairment)

Answer 15

Significant cognitive decline
* No longer able to do everyday activities

Question 16

What is an example of a registration and recall test?

Answer 16

1. Tell them to remember 3 objects
2. Distract them
3. Come back later and ask

Question 17

What is an example of a judgement test?

Answer 17

1. Given a scenario
2. Ask how they would approach the situation
3. Mark against typical response

Question 18

The Clock-Drawing Test (CDT)

Answer 18

Assess executive function and visual-spatial function

Question 19

MCI management

Answer 19

1. Treat reversible causes (e.g. meds)
2. General counselling
3. Offered 12-18m follow up

Question 20

Drug options in AD

Answer 20

1. Anti Amyloid
2. NMDA antagonist
3. Cholinesterase inhibitor

Question 21

Drug options Lewy

Answer 21

Cholinesterase inhibit

Question 22

Drug options in Parkinson

Answer 22

Trial of levodopa

Question 23

Non drug options from neurodegen treatment

Answer 23

1. Driving safety
2. Aged care planning
3. Support groups
4. Lifestyle changes