DEMENTIA

Ans:B i.e. Depression 

• Pseudodementia (Depression related cognitive dysfunctions) is found in depression.
• They have past h/o depression.
• Have more insight into their symptoms – i.e. themselves complaints of memory impairment, difficulty in sustaining attention & concentration; & reduced intellectual capacity.
• In contrast, a patient of dementia does not c/o these disturbances

Ans:B i.e. Clouding of consciousness is common

• Clouding of consciousness is a characteristic feature delirium & is helpful in differentiating it from dementia.
• The two most common causes of dementia are Alzheimer’s & multi-infarct; both of which are irreversible.

Ans:A i.e. Memory loss

Aphasia, Agnosia, Dyslexia are characteristic features of cortical dementia. So we are only left with memory loss for subcortical dementia.

B i.e. Alzheimer’s disease

A i.e. Schizophrenia

Ans: A -Alzheimer’s

Alzheimer’s disease is the most common cause of progressive dementia in older adults, but there are several causes of dementia. Depending on the cause, some dementia symptoms may be reversible.

Ans:D-Pick’s Disease

Pick’s disease is a rare condition that causes progressive and irreversible dementia.

This disease is one of many types of dementia known as frontotemporal dementia (FTD). Frontotemporal dementia is the result of a brain condition known as frontotemporal lobar degeneration (FTLD). 

Ans:C -Post Encephalitis

Ans. D. All

• These all are features of dementia
• Dementia is characterized by multiple cognitive defects that include impairment in memory, without impairment in consciousnessQ.
• The cognitive functions that can be affected in dementia include general intelligence, learning & memory, language, problem solving, orientation, perception, attention & concentration, judgement & social abilities (key words : think about a very old man who is unable to learn new things, concentrate, judge & solve problems with poor personal care, general intelligence, social abilities & communication skills.)
• Vascular dementia characteristically presents with – sudden onset in early age, stepwise & patchy progression with focal neurological signs & symptomsQ & greater preservation of personality.

Ans:D i.e.Cerebral infarcts

• Dementia of the Alzheimer type is a progressive, fatal neurodegenerative condition characterized by deterioration in cognition and memory, progressive impairment in the ability to carry out activities of daily living, and a number of neuropsychiatric symptoms.
• Symptoms appear gradually and the course is steadily progressive.
• Neuropathologically, limbic and posterior association cortices of the cerebrum are preferentially affected. Abundant neuritic plaque, neurofibrillary tangles, and neuronal loss are detected in these areas. 

C i.e., Kraepelin 

1. Benedict Morel used term demence precoce (in french) for deteriorated patients whose illness began in adolescence.
2. Emil Kraeplin translated it into dementia. PrecoxQ i.e. dementia = deteriorated cognitive process & precox = early onset
3. Eugen Bleuler coined term schizophreniaQ
4. Kahlbaum described catatoniaQ, Hacker decribed hebephrenia

C i.e. 60

Ans. Dementia is the loss of distant memory

Ans.  ‘D’ i.e., Alzheimer’s disease

Reversible causes of dementia

* Surgically treatable:- Normal pressure hydrocephalus, brain tumors (frontal lobe tumor), meningioma, subdural hematoma due to head injury, hydrocephalus.

* Medically treatable:- Depression, hypothyroidism, alcohol abuse, vitamin B 12/folate/Niacin deficiency, any metabolic or endocrine disturbance, neurosyphilis, Hashimoto’s encephalopathy, Wilson’s disease, celiac disease, Whipple’s disease, chronic meningoencephalitis, drugs and toxin (toxic dementia).

Irreversible causes of dementia:–

* Alzheimer’s disease, vascular (multi-infarct) dementia, Parkinsonism, Huntington’s chorea, Lewy body dementia, Pick’s disease.

Ans. b. Insight present (Ref Kaplan and Sadocks 9/e p1194-1198; Harrison 19/e p2602, 18/e p3309-3311) Fronto-Temporal Dementia:

• Insight is absent in Fronto-temporal dementia.
• FTD often begins in the 5′^hto 7^th decades.
• Patients with FTD often show an absence of insight into their condition.
• Common behavioral features include apathy, disinhibition, weight gain, food fetishes, compulsions, and emotional distance or loss of empathy.

Answer- D. Nystagmus

Dementia Pugilistica (DP), otherwise known as’punch-drunk syndrome’or’boxer’s dementia,” is a form of dementia that originates with repeated concussions or other traumatic blows to the head.

Symptoms of Dementia Pugilistica

• Progressively declining cognitive ability
• Physical tremors
• Difficulty in speech
• Pathological feelings of jealousy or paranoia
• Short-term memory loss
• Loss of physical coordination
• Changes in gait

Ans. A.  Lewy body dementia –

• Lewy body dementia, also known as dementia withLewy bodies, is the second most common type of progressive dementia after Alzheimer’s disease dementia.
• Protein deposits, called Lewy bodies, develop in nerve cells in the brain regions involved in thinking, memory and movement (motor control).