Alzheimer's Disease Flashcards

1
Q

Dementia is characterized by what?

A

Progressive memory impairment and at least one of:

Aphasia

Agnosia

Apraxia

Executive function disturbance

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2
Q

What is Alzheimer’s type dementia?

A

Primary dementia, progressive, irreversible

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3
Q

What are the key charatceristics of AD?

A

Global atrophy that is most pronounced in the hippocampus, temporal and frontal lobes

Enlarged lateral and 3rd ventricles

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4
Q

What is the first area to show pronounced neuronal loss?

A

Entorhinal cortex Area 28

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5
Q

What type of neuron does neurodegeneration affect the most?

A

Cholinergic neurons

E.g. Nucleus basalis of Meynert

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6
Q

Degeneration of the hippocampus results in what?

A

Decline in working memory, short-term, and eventually long-term memory

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7
Q

Degeneration of the nucleus basilis of meynart results in what?

A

Impaired selective attention, cortical activation and memory processes

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8
Q

Degeneration of the nucleus locus coeruleus results in what?

A

Diminished arousal, deficits in selective attention, disruption of pain and stress response, and mood

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9
Q

What are the 5 A’s of AD?

A

Anomia - deficit in expressive language

Aphasia - deterioration of language

Apraxia

Agnosia

Amnesia

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10
Q

What are the two major pathophysiological hallmarks of AD?

A

Tau neurofibrillary tangles

Beta amyloid senile plaques

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11
Q

What causes neurofibrillary tangles?

A

Hyperphosphorylation of Tau

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12
Q

What is granulavacuolar degneration and gliosis?

A

Granulovacuolar degeneration - generation of fluid filled space and granular debris within neurons

Gliosis - reactive microglia and astrocytes

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13
Q

What causes amyloid plaques?

A

Accumulation and aggregation of amyloid-B

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14
Q

What genetic factors result in early-onset AD?

A

Presenilin 1 and 2 genes on chromosome 21

Mutations in B-amyloid precursor protein

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15
Q

What genetic factors result in late-onset AD?

A

Apolipoprotein (APOE4 gene)

ABCA7 gene

Both involved in lipid metabolism

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16
Q

What is the role of astrocytes in AD?

A

Involved in production, degradation and removal of AB

Participiate in the inflammatory/immune responses of the CNS

Clearance of glutamate

17
Q

What is the first line of treatment for early-onset AD?

A

Acetylcholinesterase inhibitors

Donepexil, galantamine, and rivastigmine

18
Q

What is the treatment for moderate to severe AD?

A

Acetlycholinesterase inhibitor

Noncompetitive NMDA antagonist (memantine)

Reduce glutamate toxicity