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Details

TSM 110
Case 35 (dementia) round up
20
Medical
Undergraduate 2
12/17/2012

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Cards

Term
Which factors are important in establishing a clinical diagnosis of dementia>
Definition
1) A good clinical history
2) Collateral information
3) A dementia screen
4) Brain scans
5) Neuropschological testing of cognitive functions
Term
What is the puropose of a dementia screen?
Definition
To exclude treatable causes of dementia (hypothyroidism, infection or liver disease)
Term
What brain scans are used in the diagnosis of dementia?
Definition
A CT scan and a SPECT scan
Term
What is a SPECT scan used for?
Definition
Identifying vascular pathology
Term
What is a CT scan used for?
Definition
Identifying cortical atrophy or ventricular dilation
Term
What does a MMSE test?
Definition
1) Orientation
2) Registration
3) Attention and calculation
4) Recalls
5) Language
6) Read and obey
Term
What does local cognitive testing involve?
Definition
1) Frontal lobe function
2) Languange function
3) Parietal function
Term
What does global cognitive testing involve?
Definition
1) Orientation
2) Memory
3) Concentration
Term
How are registration and recall affected in early dementia?
Definition
Recall is impaired whilst registration is resonable
Term
Which area of the brain does memory depend upon?
Definition
The medial temporal lobe, especially the hippocampus
Term
What 2 types of memory are there?
Definition
Recent and remote
Term
Why is it important to distinguish learning from remembering?
Definition
Learning is typically the earliest impairment
Term
What is the role of the frontal lobe?
Definition
Flexibilty, planning and sequencing. Damage results in apathy and disinhibition
Term
How do you test frontal lobe function?
Definition
1) 3 stage command
2) Verbal fluency
3) Abstraction
4) Response inhibition
Term
How would you test response inhibition?
Definition
The luria 3 step test and the alternating hand movements test
Term
What does parietal lobe damage result in?
Definition
1) Dyspraxia
2) Ideomotor dyspraxia
3) Constructional dyspraxia
Term
How do you assess parietal lobe function?
Definition
The clock drawing test and the Rey complex figure test
Term
Which areas of the brain are associated with language function?
Definition
The frontal and temporal areas of the dominant hemisphere
Term
How do you test language function?
Definition
1) Observe word finding problems in speech
2) Test naming of objects
3) Repetition of sentences
4) Read and comprehend a sentence
5) Write a sentence (also tests dysgraphia)
Term
What MMSE score is indicative of dementia?
Definition
>24
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