Dementia

Question 1

What factors are included in the cognition?

Answer 1

Memory 
executive function 
language 
visuospatial 
personality

Question 2

Define dementia

Answer 2

someone can’t do things they used to do due to new progressive cognitive impairment which can not be explained by something else

Question 3

What are the causes of dementia?

Answer 3

Alzheimers 
vascular dementia 
Lewy body dementia 
Parkinson's dementia 
Frontotemporal dementia

Question 4

What is a good way to differentiate dementias?

Answer 4

What symptom presents first:
Alzheimers - memory loss
Lewy body - Hallucinations 
Frontotemporal - Language or behavioural changes 
Vascular - stroke

Question 5

What are the pathological abnormalities seen in dementia?

Answer 5

• accumulation of protein

- brain matter loss

Question 6

Which dementia is cause by accumulation of amyloid plaques and Tau?

Answer 6

Alzheimers

Question 7

alpha synuclein accumulation is associated with what dementia?

Answer 7

Lewy body

Question 8

What are the differential diagnosis for dementia?

Answer 8

• tumours
• hydrocephalus
• subdural haematoma
• over treated diabetes
• Thyroid disease
• HIV
• encephalitus
• temporal lobe epilepsy

Question 9

What are the other contributors to cognitive impairment?

Answer 9

• delirium, depression and anxiety
• fibromyalgia, peri menopause and long covid
• drugs e.g. anticholinergics
• sleep disturbance
• pain

Question 10

What questions should be asked in presenting complaint of memory loss?

Answer 10

• Onset - (progressive?)
• Ask about normal day
  also ask relative or someone who see’s them often
• repet themselves
• can they remember someone visiting
• recognition of family

Question 11

What are the associated symptoms of memory loss?

Answer 11

Executive function 
- can they cook 
- can they use remote controller
Visuospatial 
- can they navigate places they often visit 
Behavioural 
- short-tempered
- apathetic 
- loss of empathy 
Language 
- word-finding difficulties 
- loss of fluency 
Psychiatric 
- agitated 
- depressed/anxious
- euphoria 
- delusions/hallucinations 
- sleep disorders

Question 12

What social history questions should be asked if dementia is suspected?

Answer 12

function impairment 
- personal care 
- cooking 
- money 
- transport 
Safety 
- do they wander
- can they take medication
- do they leave oven on or leave cigarettes to burn

Question 13

What examinations should be performed in Dementia presentation?

Answer 13

• CV and resp
• Weight
• focal neurological
• extrapyramidal signs
• primitive reflexes
• cognitive assessment

Question 14

What are the types of cognitive assessment?

Answer 14

• mini mental state examination
• montreal cognitive examination
• Addenbrooke cognitive exam

Question 15

What bloods should be taken when dementia is suspected?

Answer 15

Bloods rule out other conditions:

• FBC
• ESR
• U&E
• LFTs
• calcium
• CRP
• glucose
• Thyroid functioning
• B12 and folate
• HbA1c

Question 16

What investigations should be done to assess dementia?

Answer 16

• ECG
• CT/MRI
• bloods

Question 17

What are the symptoms of pressure hydrocephalus

Answer 17

• cognitive impairment
• gait disturbance
• urinary incontinence

Question 18

What scan is used to detect Lewy body dementia?

Answer 18

DaT scan