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Overview
- 1. Delirium
- 2. Dementia
- 3. Amnesic syndrome + Transient global amnesia
- 4. Frontal lobe syndrome
- 5. Head injury
- 6. Parkinson's disease
- 7. Multiple sclerosis
- 8. Stroke
- 9. Eplilepsy
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Dementia - younger pt
- 1. Frontotemporal lobar degeneration
- 2. Huntington's disease (Huntington's chorea)
- 3. HIV dementia (HIV encephalopathy)
- 4. Normal pressure hydrocephalus
- 5. Prion diseases (transmissible spongiform encephalopathies)
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Parkinson's disease x3
- - Depression
- - Parkinson's disease dementia
- - Psychotic symptoms
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Frontotemporal lobar degeneration - FLD
- Pathology
- Clinical forms
- 1. - Pick's disease - Pick's bodies
- - FTLD-U (FLT with tau-negative ubiquinated inclusions)
- 2. - Frontotemporal dementia (frontal lobe syndrome with prominent dishibition and social/personality changes)
- - Semantic dementia (preogressive loss of understanding of verbal and visual meaning)
- - Progressive non-fluent aphasia (naming difficulties and progresses to mutism)
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Normal pressure hydrocephalus - triad
- Distortion of periventricular white matter tracts -> triad
- - dementia (subcortical)
- - unsteady gait
- - urinary incontinence
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Prion disease forms
- - Main human form Creutfeldt-Jacob disease (CJD): most common is sporadic CJD
- - Other human types: variant CJD, iatrogenic CJD, kuru
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Parkinsons' classic triad of extra-pyramidal symptoms
- - tremor (pill-rolling type)
- - rigidity (experienced as stiffness)
- - bradykinesia (slowed movement)
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Old age psy - Dementia
- 1. Alzheimer's disease
- 2. Vascular dementia
- 3. Dementia with Lewy bodies
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Quick: Alzheimer's disease
(histopath, onset, course, main features, personality)
- Plages and tangles.
- Insidious onset.
- Gradual decline.
- 4As: Amnesia, Aphasia, Agnosia, Apraxia
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Quick: Vascular dementia
(histopath, onset, course, main features, personality)
- - multiple cortical infarcts, arteriosclerosis
- - sudden onset
- - stepwise decline
- - patchy cognitive impariment
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Quick: DLB
(histopath, onset, course, main features, personality)
- - Lewy bodies
- - varies onset
- - gradual decline
- - fluctuating cognition, visual hallucinations, parkinsonian symptoms
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Mx of old age psy
- 1. Adaptations for pt
- 2. Social support
- 3. Support carers
- 4. Optimize physical health
- 5. Psy therapies
- - Behaviour approaches
- - Reminiscence therapy
- - Validation therapy
- - Multisensory therapy
- - Cognitive stimulation therapy
- 6. Psychotrophic meds
- - Treat comorbid
- - ACIs (acetylcholine inhibitors) e.g. donepezil, rivastigmine
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