B7-046 Alzheimer's Disease

Question 1

which perceptual pathway is responsible for the recognition of relationships between objects?

Answer 1

dorsal visual stream

Question 2

which perceptual pathway is responsible for object recognition?

Answer 2

ventral visual pathway

Question 3

short term memory and emotional processing occurs in the

Answer 3

limbic association area

Question 4

the front of the brain is [executive/perceptual]

Answer 4

executive

(motor planning)

Question 5

the back of the brain is [executive/perceptual]

Answer 5

perceptual

(sensory)

Question 6

language processing typically occurs on the […] side of the brain

Answer 6

left (dominant)

(symbolic reasoning)

Question 7

pattern reasoning occurs in the […] side of the brain

Answer 7

right (non-dominant)

Question 8

functions of the dominant hemisphere [5]

Answer 8

language
skilled motor formulation
arithmetic
trained musical ability
sense of direction from written instructions

Question 9

functions of the non-dominant hemisphere [5]

Answer 9

prosody (emotion conveyed in tone)
visual-spatial analysis
arithmetic (estimates)
untrained musical ability
sense of direction from spatial orientation

Question 10

limitations of clinical mental status evaluations [2]

Answer 10

executive function
pattern reasoning

Question 11

the trails test and word fluency tests what cognitive domain?

Answer 11

executive function

Question 12

if a patient has difficulties with multiple aspects of the clinical mental status exam, the pattern is […]

Answer 12

diffuse

Question 13

when the […] systems are affected, the elementary neurological exam is abnormal

Answer 13

subcortical

(helps localize to subcortical vs cortical lesion)

Question 14

rigidity and weakness is a sign of a […] lesion

Answer 14

subcortical

(have difficulties getting onto exam table)

Question 15

alzheimer’s causes a […] dementia

Answer 15

diffuse cortical

Question 16

the pathology of Alzheimer’s is characterized by […]

Answer 16

plaques and tangles

Question 17

typical initial symptom of Alzheimer’s

Answer 17

short term memory problem

(usually starts in mesial temporal lobe/hippocampus)

Question 18

why is the elementary neuro exam normal in Alzheimer’s patients?

Answer 18

primary sensory and motor cortices are not affected until late stage

(true of most cortical diseases)

Question 19

MOA of tacrine, donepezil, galantamine, and rivastigmine?

Answer 19

centrally acting cholinesterase inhibitors

Question 20

MOA of memantine

Answer 20

NMDA antagonist

Question 21

MOA of aducanumab

Answer 21

anti-amyloid monoclonal antibodies

Question 22

most common cause of dementia in older adults

Answer 22

Alzheimer’s

Question 23

cortical dementias [2]

Answer 23

Alzheimers
frontotemporal

Question 24

subcortical dementias [2]

Answer 24

vascular dementias
diffuse lewy body dementia

Question 25

strongest risk factor for Alzheimer's

Answer 25

advanced age

Question 26

area of the brain that decodes sound symbols

Answer 26

wernickes

Question 27

area of the brain that encodes sound symbols

Answer 27

Broca's

Question 28

connection between Broca's and Wernicke's

Answer 28

arcuate fasiculus

Question 29

important parts of language assessment [3]

Answer 29

fluency comprehension repetition

Question 30

non-fluent speech [broca/wernickes]

Answer 30

Broca's aphasia

Question 31

fluent nonsensical speech [broca/wernickes]

Answer 31

Wernicke's aphasia

Question 32

fluent speech comprehension intact but cannot repeat

Answer 32

conduction aphasia (lesion in arcuate fasciculus)

Question 33

fluent speech poor comprehension repetition intact

Answer 33

trans-cortical sensory aphasia (usually from watershed stroke)

Question 34

non-fluent speech comprehension intact repetition intact

Answer 34

trans-cortical motor (usually from watershed stroke)

Question 35

hallmark of a transcortical lesion causing aphasia

Answer 35

able to repeat

Question 36

an infiltrating tumor of the dominant hemisphere is most likely to affect [...] function

Answer 36

language --> aphasia

Question 37

most uncommon dementia

Answer 37

frontal temporal

Question 38

dementia presenting with dysexecutive function followed by non-fluent aphasia

Answer 38

frontal temporal

Question 39

non-fluent speech preserved comprehension repetition preserved

Answer 39

transcortical motor aphasia (Broca's is still intact, but has been dissociated from anterior association areas)

Question 40

non-fluent speech preserved comprehension no repetition

Answer 40

Broca's

Question 41

what characterizes mild cognitive impairment?

Answer 41

only one cognitive domain is affected

Question 42

patients with [...] dementia have gait abnormalities

Answer 42

subcortical

Question 43

pathologic changes due to AD are first visible in the [...] cortex

Answer 43

medial temporal

Question 44

fluent speech preserved comprehension no repetition

Answer 44

conduction aphasia (Wernickes is disconnected from Brocas)

Question 45

fluent speech no comprehension repetition impaired

Answer 45

Wernicke's

Question 46

[...] aphasias are characterized by preserved repetition

Answer 46

transcortical

Question 47

needing assistance to sit on the exam table characterizes [...] dementia

Answer 47

subcortical

Question 48

decline in cognitive ability with intact consciousness

Answer 48

dementia

Question 49

reversible causes of dementia [5]

Answer 49

depression hypothyroidism vitamin B12 deficiency neurosyphilis normal pressure hydrocephalus

Question 50

strongest risk factor for AD

Answer 50

advanced age

Question 51

Down syndrome patients have an increased risk of develop AD as the APP protein is located on chromosome

Answer 51

21

Question 52

what neurotransmitter is decreased in AD?

Answer 52

ACh

Question 53

how does APOE2 affect an individual's chance of getting Alzheimer's?

Answer 53

decreased risk of sporadic form

Question 54

how does APOE4 affect an individual's chance of getting Alzheimer's?

Answer 54

increased risk of sporadic form

Question 55

AD is characterized by widespread [...] atrophy

Answer 55

cortical (especially the hippocampus)

Question 56

higher order language deficit

Answer 56

aphasia

Question 57

motor inability to produce speech

Answer 57

dysarthia

Question 58

[...] area is in the inferior frontal gyrus of the frontal lobe

Answer 58

Broca's

Question 59

associated with a defect in language production

Answer 59

Broca's

Question 60

patients with [...] aphasia will appear frustrated, as insight is intact

Answer 60

Brocas

Question 61

[...] area is in the superior temporal gyrus of the temporal lobe

Answer 61

Wernicke's

Question 62

[...] aphasia is associated with impaired language comprehension

Answer 62

wernicke's

Question 63

Do patients with Wernicke's aphasia have insight?

Answer 63

No Werknickes is Word salad

Question 64

caused by damage to the arcuate fasiculus

Answer 64

conduction aphasia

Question 65

hemispatial neglect syndrome indicates a lesion in the [...]

Answer 65

nondominant parietal cortex (agnosia of the contralateral side of the world)

Question 66

agraphia, acalculia, finger agnosia, and left-right disorientation indicates a lesion where?

Answer 66

dominant (left) parietal cortex

Question 67

a lesion in the frontal lobe can cause what symptoms

Answer 67

disinhibition hyperphagia impulsivity loss of empathy impaired executive function akinetic mutism (seen in frontotemporal dementia)