Dementia

Question 1

Dementia

Answer 1

progressive impairment in one of:

• learning and memory
• language
• social cognition
• problem solving

Question 2

Mild cognitive impairment

Answer 2

Stage between cognitive decline of normal ageing and dementia
Struggle with memory, reasoning, attention etc

Question 3

What is normal pressure hydrocephalus

Answer 3

Reversible cause of dementia, caused by reduced CSF absorption at arachnoid villi - following head injury, subarachnoid or meningitis

Question 4

Sx normal pressure hydrocephalus

Answer 4

Urinary incontinence
Dementia
Gait abnormality - similar to Parkinson’s

Question 5

Tx normal pressure hydrocephalus

Answer 5

Ventriculoperitoneal shunting

Question 6

MRI AD

Answer 6

Hippocampal atrophy with sparing of motor and sensory cortex - bilateral and symmetrical

Question 7

MRI FTD

Answer 7

Bilateral frontal and temporal atrophy

Left>right

Question 8

MRI LBD

Answer 8

Medial temporal lobe atrophy

Question 9

Sporadic vs genetic AD

Answer 9

• Sporadic is complex, mediated by APOE e4 homozygosity

- Genetic is autosomal dominant, mediated by PSEN 1 and 2 = increased AB42 production

Question 10

Sub-types FTD

Answer 10

• Behavioural variant: behavioural and executive dysfunction → frontal and temporal lobe affected
• Non-fluent primary progressive aphasia - people cannot find words to speak
• Semantic variant primary progressive aphasia - knowledge and naming difficulties

Question 11

Prion dementia

Answer 11

• Caused by propagation of misfolded prion proteins in CNS
• Protein-resistant amyloid containing prion protein (or scrapie prion protein) (PrPSc)
• PrPSc has high degree of B pleated sheet structure - this occurs spontaneously
• Cruedtzfelt-Jakob disease
• Normal prion proteins are in everyone - when unfolded it forms Prion SC form, which causes disease. This causes a chain reaction where all prion proteins are consequently misfolded. The resulting ‘sticky’ protein attaches to neurons and causes them to die

Question 12

Vascular dementia

Answer 12

Infarcts and haemorrhages + progressive demyelination, axon injury, astrocytosis etc

Question 13

Cause of Creutzfeldt-Jakob disease

Answer 13

Progressive neurological condition caused by prion proteins - cause amyloid folds in B-pleated sheets

Question 14

Sx Creutzfeldt-Jakob disease

Answer 14

Dementia
Myoclonus
Cognitive deficits