Alzheimer's Disease

Question 0

A step-wise, sudden deterioration in cognition including episodes of confusion , aphasia, and slurred speech

Answer 0

Cerebrovascular disease

Question 1

A gradual on-set of short-term memory loss and functional impairment in more than 1 domain

Answer 1

Dementia

Question 2

Acute cognitive impairment with clouded sensorium

Answer 2

delirium

Question 3

Phenomenon that a high-frequency stimulus will change the neuron in a way in which the activity continues to be higher even with decreased stimulation

Answer 3

Long-term potentiation (LTP)

Question 4

Alzheimer’s agent that is an uncompetitive NMDA receptor antagonist

Answer 4

Memantine

Question 5

Area of the brain that contains the cell bodies of neurons that synthesize acetylcholine

Answer 5

basal forebrain nuclei

Question 6

Cholinesterase that has a higher concentration in the brain and is relatively selective for acetylcholine

Answer 6

acertylcholinesterase

Question 7

Function of acetylcholinesterases

Answer 7

terminate cholinergic transmission

Question 8

acetylcholinesterase that is mainly localized in the peripheral tissues and glial cells and is relatively non-selective

Answer 8

butyrylcholinesterase

Question 9

Isoform of acetylcholinesterase that is preferentially lost with Alzheimer’s progression

Answer 9

G4 (tetromer)

Question 10

3 cholinesterase inhibitors commonly used in treatment of Alzheimer’s disease

Answer 10

1. Donepezil
2. Rivastigmine
3. Galantamine

Question 11

Cholinesterase inhibitor that is selective for AChE over BuChE

Answer 11

Donepezil

Question 12

Cholinesterase inhibitor that is selective for both AChE and BuChE and has a greater potency for G1 than G4

Answer 12

Rivastigmine

Question 13

Cholinesterase inhibitor that is 50x more selective for AChE over BuChE and is also a positive allosteric modulator of nicotinic acetylcholine receptors

Answer 13

Galantamine

Question 14

Abnormality that occurs within neurons in Alzheimer’s disease

Answer 14

neurofibrillary tangles

Question 15

Extracellular abnormality that occurs with Alzheimer’s disease

Answer 15

amyloid plaques

Question 16

Secretases that must cleave amyloid precursor protein (APP) for abnormal beta-amyloid to be formed

Answer 16

beta and gamma secretases

Question 17

Molecules that become hyperphosphorylated and clump together in neurofibrillary tangles

Answer 17

tau

Question 18

Brain imaging that can be done to look for beta-amyloid and diagnose probable Alzheimer’s

Answer 18

Positive Emission Tomography (PET) scan

Question 19

Primary screening tool for Alzheimer’s disease that gives patients a score between 0-30

Answer 19

Mini Mental Status Exam (MMSE)

Question 20

Score range on MMSE that designates normal cognitive function

Answer 20

24-30

Question 21

Score on MMSE that designates mild dementia

Answer 21

18-23

Question 22

Score on MMSE that designates moderate dementia

Answer 22

10-17

Question 23

Score on MMSE that designates severe dementia

Answer 23

<10

Question 24

Cognitive function test that involves giving patients 3 words to remember and having them perform a clock draw test

Answer 24

Mini Cog Test

Question 25

Class of drugs that have an unapproved use in dementia due to increased mortality with us in this population

Answer 25

Atypical antipsychotics

Question 26

Dosing regimen for donepezil

Answer 26

5 mg QHS for 6 weeks then 10 mg/day

Question 27

Dosing regimen for rivastigmine

Answer 27

1.5 mg BID and increase by 1.5 mg BID every 2 weeks up to 6 mg BID

Question 28

Dosing regimen for galantamine

Answer 28

4 mg BID x4 weeks then increase to 8 mg BID then increase to 12 mg BID

Question 29

Severe dermatologic disease that has been linked to galantamine

Answer 29

Stephen’s Johnson Syndrome

Question 30

Dosing regimen for memantine

Answer 30

5 mg QD then increase at minimum 1 week intervals to 10 mg/day (5mg BID), then 15 mg/day (5 mg and 10 mg in separate doses), then 20 mg/day (10 mg BID)