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Neuro > Alzheimers > Flashcards

Alzheimers Flashcards

1
Q

most epileptic part of the human brain

A

hippocampus

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2
Q

HM characteristics, conclusion?

A

LT memory was impaired, but other cognitive functions were intact; function of LT memory is separate from other cognitive functions

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3
Q

bundle of white matter fibers leaving the hippocampus twd the thalamus/BG/forebrain

lesion in this structure causes?

A

fornix

lesion –> anterograde amnesia (cannot provide ACh to hippocampus)

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4
Q

another structure crucial to memory formation?

A

medial temporal lobes

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5
Q

associative memory: hearing a sound and assoc w a person and his life story

tying shoes

A

hippocampus

not assoc w/hippocampus - don’t need to remember contextual features

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6
Q

declarative (explicit) memory

nondeclarative (implicit) memory

A

medial temporal dependent (event learning; recall/recognition)

independent

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7
Q

common complication of dural atrophy

A

subdural hematoma (easily torn)

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8
Q

Senile plaques

A

EC deposition of fibrillar amyloid-B (inflammation, cytokines, complement etc)

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9
Q

degeneration of neurons via?

A

phosphorylation of tau protein leads to aggregation and degeneration

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10
Q

amyloid angiopathy

A

found in vessels and leads to breakage

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11
Q

role of microglia

A

activated and phagocytose debris

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12
Q

amyloid hypothesis

A

AB generation leads to adverse effects; defect in the gamma secretase –> breaks down precursor amyloid in abnormal way generating B-Amyloid –> oxidation, aggregation, inflammation, tau hyperphosphrylation (and microtubules) –> plaques and tangles –> cell death, NT deficit –> cognitive and behavioral changes

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13
Q

definition of dementia (MND): multiple realms

A 
impaired memory
disturbed language
visuospatial abnormalities
decreased problem-solving, abstraction and other exec fxns
reduced attention
apraxia
agnosia

end-stage includes deficits in them all

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14
Q

most common cause of dementia?

A

alzheimers

the older you are, the more common the cause of dementia is alzheimers

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15
Q

core issue of alzheimers

A

memory loss

as progresses, further into disease further back memory recall problems become

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16
Q

visuospatial problems due to

A

parietal damage

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17
Q

can’t groom, take meds, feed oneself

A

severe alzheimers

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18
Q

common mut in alzheimers
rare
downs

A

apo-e4 (double risk)

rare: secretases
downs: have an extra copy of the amyloid precursor protein gene so deposit more amyloid since birth

19
Q

increase in which enzyme in alzheimers?

A

butyrocholinesterase

20
Q

sudden onset of problems w/attention and arousal

A

delirium

irreversible

21
Q

central symptom of alzheimers

A

amnesia

22
Q

5 A’s of alzheimers

A

Aphasia, apraxia, agnosia, executive fxn (abstract reasoning, activities of daily living)

23
Q

conscious, recollective memory

past experiences influence present performance in absence of specific memory

A

explicit/declarative

implicit/nondeclarative

24
Q

declarative (not non declarative) memory impaired in what kind of amnesia?

A

anterograde

25
Q

type of declarative LTM that includes where/who with/what time etc –> context/source

type of declLTM that contains factual info but not assoc w specific event

A

episodic memory

semantic memory

26
Q

HM lobectomy?

A

bilateral medial temporal lobe (hippocampus)

language remained normal, IQ increased

27
Q

role of hippocampus

A

encoding as well as retrieval

28
Q

brain atrophy most severe where?

A

frontal/temporal lobes

29
Q

accumulations of paired helical filaments in neuronal cytoplasm; birefringent under polarized light and visualized using silver stain

A

neurofibrillary tangles

30
Q

genetics of alzheimers
which two chromosomes?
which two genes?
which two NT’s are decreased?

A 
dominant!
chromosome 14: presenilin-1
chromosome 1: presenilin-2
apoE-e4 --> higher risk and earlier onset
apoE-e2 is protective
ACh and somatostatin
31
Q

single most powerful risk factor for dementia?

other risk factors?

A

age –> 45% over 95y have it

genetics (apoE4, family hx of alz, hx of TBI, dearth of education, late-life depression, CV risk fx

32
Q

most common cause of dementia?

core sx of dementia?

A

alzheimer’s
amnesia (2-3y prior to dementia dx)
STM first, then LTM
aphasia, visuospatial, exec dysfxn

33
Q

criteria for MND due to alzheimers

A

A. Criteria met for major/mild NCD
B. Insidious onset/gradual progression of impairment in 1+ cognitive domains
C. Criteria met for alzheimers (probable if either of the following, otherwise “possible”):
1. causative genetic mutation
2. all 3 of the following: a) decline in memory/learning and 1+ other domain; b) steadily prog/gradual decline in cognition w/o extended plateaus; c) no evidence of mixed etiology

34
Q

prognosis

A

most pts btwn 75-85y

6-12y from dx to death

35
Q

donepezil, galantamine, rivastigmine, memantine not effective for?

A

frontotemporal dementia

36
Q

meds used in dementia

which med assoc w incr mortality in elders w/dementia?

A

SSRI’s and atypical antipsychotics

atypical antipsychotics

37
Q

strokes here lead to problems with attention

strokes here lead to apathy, disinhibition

A

parietal lobe

frontal

38
Q

sudden change in cognitive fxn indicates?

A

cerebrovascular incident

39
Q

the onset of cognitive sx at least 1y after onset of motor sx, impairment due to Lewy bodies

1) fluctuating sx, 2) visual hallucinations, 3) cognitive impairment, 4) less severe parkinsonian sx than in parkinsons

levy bodies found where?

A

parkinson’s disease dementia

DLB

cerebral cortex

40
Q

presence of tau inclusion bodies on histo
lobar degeneration of frontal/temporal lobe
behavioral disturbance/aphasia

A

FTD

onset 50-65y

41
Q

when do you know dx of FTD?

course of FTD? death when?

A

when tx (antidepr/mood stabz) not effective
more rapid than other dementias
death w/in 5y of dx

42
Q

other causes of dementia

A 
huntington's
CJD
neurosyphilis
wernicke-korsakoff syndrowm (alcohol dementia)
CTE
CNS tumors
HIV/AIDS
43
Q

reversible causes of dementia

A

depression, hypothyroid, B12 def, pressure hydrocephalus, subdural hematoma

Neuro (14 decks)

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