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Flashcards in degenerative diseases of the CNS Deck (29)
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1
Q

what are some common feature of neurodegenerative disease?

A

usually late onset
gradual progression
neuronal loss
structural imaging often normal

2
Q

what is dementia defined as?

A

syndrome consisting of progressive impairment of multiple domains of cognitive function i alert patient leading to loss of acquired skills and interference in occupational and social role

3
Q

what are the most common causes of late onset dementia?(65+ yrs)

A

alzheimers (55%)
vascular (20%)
lewy body(20%)
others(others)

4
Q

what are the most common causes of young onset dementia? (<65 yrs)

A

alzheimers (33%)
vascular (15%)
frontotemporal (15%)
other (33%) (toxic, genetic, infection, inflammatory)

5
Q

what conditions can “mimic” dementia?

A

hydrocephalu
tumour
depression

6
Q

what are some treatable causes of dementia?

A

vitamin b12 deficiency
thyroid disease
HIV, syphilis

7
Q

what examinations would you perform to help diagnose dementia?

A

cognitive function
neurological
vascular

8
Q

what investigations are appropriate to help diagnose dementia?

A

bloods
CT/MRI
CSF
EEG

9
Q

what are the 2 screening tests used to assess cognitive function?

A
mini mental (MMSE)
montreal (MOCA)
10
Q

what type of dementia would a stepwise progression indicate?

A

vascular

11
Q

what would a rapid progression of dementia indicate?

A

creutzfeld jacob disease

12
Q

what are some other neurological signs that could help show the cause of dementia?

A

abnormal movements (huntingtons)
parkinsonism (lewy body)
myoclonus (CJD)

13
Q

what type of dementia is associated with alzheimers disease?

A

temporo-parietal dementia

14
Q

what are some features of temporo parietal dementia?

A

early memory disturbance
language and visuospatial problems
personality preserved until later

15
Q

what are some features of frontotemporal dementia?

A

early change in personality/behaviour
often change in eating habits
early dysphasia
memory/visuospatial relatively preserved

16
Q

what pharmacological treatments are used to treat alzheimers?

A
cholinesterase inhibitors
NMDA antagonist (memantine)
17
Q

what are some examples of cholinesterase inhibitors?

A

donepezil
rivastigmine
galantamine

18
Q

what features must a patient present with 2 or more of to be classed as having “parkinsonism”?

A

bradykinesia
rigidity
tremor
postural instability

19
Q

what is the pathology of parkinsonism?

A

loss of dopamine in the basal ganglia

20
Q

what causes parkinsonism?

A

idiopathic parkinsons disease
drug induced
vascular parkinsonism
parkinson plus syndromes

21
Q

what are some examples of parkinsons plus syndromes?

A

multiple system atrophy

progressive supranuclear palsy/corticobasal degeneration

22
Q

how is parkinsons disease diagnosed?

A

bradykinesia + 1 or more of: tremor, rigidity or postural intability
no other cause/atypical features
slowly progressive

23
Q

what does parkinsons disease have a good response to?

A

dopamine replacement treatment

24
Q

what imaging modality is useful for diagnosing/staging parkinsons disease?

A

dopamine transporter SPECT

25
Q

what are some examples of dopamine agonists?

A

ropinirole
pramipexole
rotigotine

26
Q

what is a drug used to convert tyrosine to dopamine?

A

levodopa

27
Q

what are some drug induced complications of parkinsons disease?

A

motor fluctuations - levodopa wears off
dyskinesias - involuntary movements
hallucinations

28
Q

what are some non drug induced complications of parkinsons?

A
depression
dementia
autonomic
speech, swallow
balance
29
Q

what drugs can prolong levodopas half life?

A

MAO-B inhibitors
COMT inhibitors
slow release levodopa