Alzheimers Flashcards

1
Q

amyloid plaques are ___ and consist of ______

A

extracellular, AB peptide (amloid beta)

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2
Q

neurofibrillary tangles are ____ and consist of _____

A

intracellular, hyperphosphorylated tau

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3
Q

a feature of neurons with tangles and close to amyloid plaques is destruction of ______

A

synapses

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4
Q

snapse loss results in reduced what

A

neurotransmitters - esp. acetylcholine, dopamine, serotonin, NE

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5
Q

APP gene is located on

A

chromomosome 21

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6
Q

things leading to early onset AD

A

mutations in APP
mutations in PSENs

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7
Q

things leading to 4th decade of life AD

A

Down syndrome

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8
Q

normal cleavage of AB from APP is by

A

alpha secretase

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9
Q

abnomal cleavage of AB from APP is by

A

beta and gamma secretase

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10
Q

which amyloid beta form can form more amloid fibrils

A

AB42 > AB40

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11
Q

mutations in APP lead to more

A

cleavage by beta and gamma so more AB42

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12
Q

mutations in PSEN1 or PSEN2 do what

A

alter the gamma secretase cleavage, more AB42

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13
Q

AB aggregation promotes what

A

tau hyperphosphorylation

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14
Q

tau hyperphosphorylation leads to what

A

neurofibrillary tangles, cytoskeletal abnormalities, disruption axonal trafficking

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15
Q

AB aggregation triggers ____ activation

A

microglia
immune cell

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16
Q

activated microglia do what

A

release inflammatory cytokines that cause neuroinflammation
PGs, ILs, TNF-a
release reactive nitrogen and oxygen species that cause oxidative stress

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17
Q

activated microglia cause what

A

neuroinflammation
oxidative stress

18
Q

ApoE 2 vs ApoE4

A

2 - increased risk AD
4 - decreased risk AD

19
Q

cholinesterase inhibitors

A

donepezil
rivastigmine
galantamin

20
Q

donepezil MOA

A

specific reversible inhibitor AcE

21
Q

rivastigmine MOA

A

inhiitor AcE and butyrlcholinesterase

22
Q

galantamine MOA

A

selective reversible inhibitor AcE and enhances action of acetylcholine on nicotinic receptors

23
Q

anti-glutamtergic drug

A

memantine

24
Q

memantine MOA

A

NMDA antagonism that blocks glutamatergic neurotransmission via a noncompetitive mechanism,
REDUCES EXCITOTOXICITY

25
Q

what is florbetapir

A

radiolabeled agent that binds b - amyloid and is visualized by PET scanning

26
Q

dementia with Lewey bodies

A

cognitive decline and Parkinsons sx
VISUAL HALLUCINATIONS
cortical lewey bodies

27
Q

frontotemporal dementia

A

Picks Disease
disinhibited behavior
tau accumulations (Picks bodies)

28
Q

drug classes with anticholinergic burden

A

skeletal muscle relaxants
tricyclic antidepressants
antihistamines / emetics
bladder antispasmodics

29
Q

change in MMSE score of what in 1 year is bad

A

3-4 points

30
Q

scales used to assess cognitive function

A

MMSE, MoCA

31
Q

first line therapy dementia

A

cholinesterase inhibitors
donepezil
rivastigmine
galantamine

32
Q

when to use NMDA receptor antagonists?

A

moderate to severe dementia

33
Q

which drug should you not take with memantine

A

carbonic anhydrase inhibitors

34
Q

dementia MABs IV

A

aducanumab
lecanemab

35
Q

aducanemab and lecanemab require what

A

brain MRI, ARIA
presence of amyloid beta pathology prior to initaition

36
Q

what nonpharm intervention is more efficacious than antipsychotics for agitation

A

outside activities

37
Q

agitation intervention

A

take outside
distraction techniques

38
Q

antipsychotics for psychosis

A

risperidone and quetiapine

39
Q

box warning antipsychotics

A

death or stroke increased in dementia

40
Q

antipsychotics are not useful for what

A

repetitive behaviors or yelling

41
Q

antidepressants used dementia

A

SSRIs, avoid paroxetine