Cognitive Neurology Flashcards

1
Q

define cognition

A

the mental action of acquiring knowledge through thought, experience and senses

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2
Q

name the different domains of cognition

A
memory
executive function eg decision making/problem solving
language
social function
attention
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3
Q

dementia is defined as significant cognitive decline in at least _ cognitive demain

A

1

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4
Q

a viral encephalitis will affect what cognitive domains?

A

memory
behaviour change
language

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5
Q

a head injury will affect what cognitive domains?

A

attention
memory
executive dysfunction

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6
Q

what are the features of transient global amnesia

A

abrupt onset antegrade amnesia with preserved knowledge of self that lasts <24 hours
usually only happens once

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7
Q

who gets transient global amnesia?

A

> 50

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8
Q

what is anterograde amnesia?

A

loss of ability to create new memories after the event that caused the amnesia

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9
Q

what are the features of transient epileptic amnesia?

A

forgetful, repetitive questioning
very short lived (20-30mins)
recurrent

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10
Q

transient epileptic amnesia is associated with what problem?

A

temporal lobe seizures

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11
Q

patient completes complex tasks but has no memory of doing them….

A

transient epileptic amnesia

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12
Q

what infections can cause cognitive impairment?

A

HIV syphilis

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13
Q

metabolic causes of cognitive impairment?

A

thyroid
calcium
hyponatraemia

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14
Q

everyday forgetfulness impacting on functioning indicates…

A

functional cognitive impairment

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15
Q

presentation of functional cognitive impairment

A

fluctuating symptoms in a highly functioning person

symptoms can get better or worse unlike in dementia

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16
Q

what should be excluded in a patient with suspected functional cognitive impairment

A

mood disorder

dementia

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17
Q

most common human prion disease?

A

creutzfeldt-jakob disease (CJD)

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18
Q

what happens in prion disease?

A

neurodegenerative proteinopathy of the prion protein

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19
Q

most common type of CJD? what age does it present in

A

sporadic

60s

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20
Q

clinical features of sporadic CJD?

A

rapid onset dementia
neurological signs
myoclonus
death very quickly (4 months)

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21
Q

most likely cause of CJD in young people?

A

genetic

22
Q

patients with functional cognitive impairment tend to have had very good memories before the onset of their symptoms T or F

A

T

23
Q

Ix of prion disease?

A

MRI

LP

24
Q

histopathological appearance of CJD

A

spongiform changes as a result of neuron loss

25
Q

main pathology in dementia syndromes

A

neurodegenerative proteinopathy

26
Q

early onset alzheimers is onset before age __

A

65

27
Q

alzheimers shows degeneration of what parts of the brain?

A

medial hippocampus

parietal lobes later

28
Q

night blindness and visuospatial disturbance in a patient with alzheimers indicates what kind of brain pathology

A

posterior cortical atrophy

29
Q

a patient with posterior cortical atrophy would struggle with what part of the addenbrookes test?

A

drawing shapes

30
Q

what is the most common form of progressive primary aphasia in alzheimers patients?

A

difficulty repeating sentences (logopenic aphasia)

31
Q

“staccato speech” is common in what form of dementia?

A

fronto-temporal

32
Q

Ix of alzheimers

A

MRI
SPE-CT
LP

33
Q

CSF findings in alzheimers?

A

reduced amyloid

increased tau protein

34
Q

Tx of alzheimers?

A

address vascular risk factors

acetylcholine agonists eg cholinesterase inhibitors

35
Q

frontotemporal dementia is a/an ___ onset dementia

A

early

36
Q

what are the early features of FT dementia?

A

early frontal features eg disinhibition, apathy, loss of empathy, behaviour issues
semantic aphasia (naming problems)
loss of insight

37
Q

pick bodies are present in what dementia

A

FT

38
Q

increased tau and normal amyloid on CSF indicates what dementia

A

FT

39
Q

MRI of FT dementia presents with atrophy of the ____ lobes

A

frontotemporal

40
Q

Tx of FT dementia?

A

trazadone

antipsychotics

41
Q

vascular dementia is __ onset

A

late

42
Q

Tx of vascular dementia?

A

vascular risk factors +/-

cholinesterase inhibitor

43
Q

presence of extrapyramidal features is a sign of what dementia?

A

lewy body

44
Q

parkinsons dementia is most similar in presentation to what dementia?

A

lewy body dementia

45
Q

huntingtons presents with __ onset dementia

A

early

46
Q

loss of caudate heads on MRI…

A

late huntingtons dementia

47
Q

symptoms of huntingtons dementia

A

frontal problems from dysexecutive syndrome

slowed speed of processing

48
Q

Tx of huntingtons dementia

A

mood stabilisers

chorea management

49
Q

what dementia patients should be referred to old age psychiatry?

A

> 65

gradual onset

50
Q

what dementia patients should be referred to neurology?

A

<65

any unusual features

51
Q

name the components of a dementia blood screen

A
B12
TFTs
syphilis
HIV
Ca
genetics