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16 Cards in this Set
- Front
- Back
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What are the two types of delirium and what are there clinical signs? |
Hypoactive - quiet, lethargic, withdrawn Hyperactive - hyper-aroused, irritable, mood liability |
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When should anti-psychotics be considered in patients with dementia? |
Rarely - to reduce patient stress, intervene against threatening behaviour, trying to leave the building or excessive calling out |
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What are the typical findings of severe late stage dementia? |
Total aphasia, inability to walk, postural instability, contractures, urinary / faecal incontinence, myoclonic jerks, progressive weight loss and high risk of pressure sores |
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What is the most common cause of dementia? |
Alzheimer's Disease (followed by vascular dementia and lewy body dementia) |
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What are the key features of dementia? |
Global impairment of higher cortical functioning occurring in clear consciousness, progressing and present over more than 6 months |
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What is the typical presentation of Alzheimer's? |
Insidious onset with gradual deterioration, on histology plaques and tangles are observed alonside a deficit in cholinergic transmission |
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What are the risk factors for Alzheimer's development? |
Age, female sex, genetics (family links), head injury and environmental stressors |
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What is the typical presentation for vascular dementia? |
Sudden onsets with step-wise deterioration, mood and behavioural changes with insight preserved for longer periods, atherosclerosis is key with small vessel and thrombotic events featuring heavily |
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What are the risk factors for the development of vascular dementia? |
Smoking, diabetes, high cholesterol, high blood pressure and male sex |
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What are the two Parkinson's related dementias? |
Parkinson's dementia and Lewy body dementia |
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What is the typical presentation of Lewy Body Dementia? |
Fluctuating cognition with vivid visual hallucinations, mild parkinsonian features causing repeated falls (neuroleptic sensitivity), memory loss is a marked feature of late disease, histology shows Lewy bodies |
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What is the typical presentation of Fronto-temporal dementia (Pick's disease)? |
Apathy, reduced motivation, self-neglect, disinhibition, reduced social awareness, lack of judgement, change in personality, memory loss is variable with langauge difficulty being more prominent |
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What are the differentials of dementia? |
Depression (pseudodementia), delirium, organic dementia (hypothyroid, CJD, alcohol, subdurals) and premorbid low IQ |
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What are the 4 genetic Alzheimer's diseases? |
Early - Presenilin gene 1 and 2, APP gene Late - ApoE4 gene |
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How can Alzheimer and Lewy body dementia be treated? |
Anti-cholinesterase and NMDA antagonist (Donepizil, Memantine) |
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How can Vascular Dementia be treated? |
Low dose aspirin, statin, manage BP and blood glucose alongside typical lifestyle advice |
