B7-046 Alzheimer's Disease Flashcards
which perceptual pathway is responsible for the recognition of relationships between objects?
dorsal visual stream
which perceptual pathway is responsible for object recognition?
ventral visual pathway
short term memory and emotional processing occurs in the
limbic association area
the front of the brain is [executive/perceptual]
executive
(motor planning)
the back of the brain is [executive/perceptual]
perceptual
(sensory)
language processing typically occurs on the […] side of the brain
left (dominant)
(symbolic reasoning)
pattern reasoning occurs in the […] side of the brain
right (non-dominant)
functions of the dominant hemisphere [5]
language
skilled motor formulation
arithmetic
trained musical ability
sense of direction from written instructions
functions of the non-dominant hemisphere [5]
prosody (emotion conveyed in tone)
visual-spatial analysis
arithmetic (estimates)
untrained musical ability
sense of direction from spatial orientation
limitations of clinical mental status evaluations [2]
executive function
pattern reasoning
the trails test and word fluency tests what cognitive domain?
executive function
if a patient has difficulties with multiple aspects of the clinical mental status exam, the pattern is […]
diffuse
when the […] systems are affected, the elementary neurological exam is abnormal
subcortical
(helps localize to subcortical vs cortical lesion)
rigidity and weakness is a sign of a […] lesion
subcortical
(have difficulties getting onto exam table)
alzheimer’s causes a […] dementia
diffuse cortical
the pathology of Alzheimer’s is characterized by […]
plaques and tangles
typical initial symptom of Alzheimer’s
short term memory problem
(usually starts in mesial temporal lobe/hippocampus)
why is the elementary neuro exam normal in Alzheimer’s patients?
primary sensory and motor cortices are not affected until late stage
(true of most cortical diseases)
MOA of tacrine, donepezil, galantamine, and rivastigmine?
centrally acting cholinesterase inhibitors
MOA of memantine
NMDA antagonist
MOA of aducanumab
anti-amyloid monoclonal antibodies
most common cause of dementia in older adults
Alzheimer’s
cortical dementias [2]
Alzheimers
frontotemporal
subcortical dementias [2]
vascular dementias
diffuse lewy body dementia
strongest risk factor for Alzheimer’s
advanced age
area of the brain that decodes sound symbols
wernickes
area of the brain that encodes sound symbols
Broca’s
connection between Broca’s and Wernicke’s
arcuate fasiculus
important parts of language assessment [3]
fluency
comprehension
repetition
non-fluent speech [broca/wernickes]
Broca’s aphasia
fluent nonsensical speech [broca/wernickes]
Wernicke’s aphasia
fluent speech
comprehension intact
but cannot repeat
conduction aphasia
(lesion in arcuate fasciculus)
fluent speech
poor comprehension
repetition intact
trans-cortical sensory aphasia
(usually from watershed stroke)
non-fluent speech
comprehension intact
repetition intact
trans-cortical motor
(usually from watershed stroke)
hallmark of a transcortical lesion causing aphasia
able to repeat
an infiltrating tumor of the dominant hemisphere is most likely to affect […] function
language –> aphasia
most uncommon dementia
frontal temporal
dementia presenting with dysexecutive function followed by non-fluent aphasia
frontal temporal
non-fluent speech
preserved comprehension
repetition preserved
transcortical motor aphasia
(Broca’s is still intact, but has been dissociated from anterior association areas)
non-fluent speech
preserved comprehension
no repetition
Broca’s
what characterizes mild cognitive impairment?
only one cognitive domain is affected
patients with […] dementia have gait abnormalities
subcortical
pathologic changes due to AD are first visible in the […] cortex
medial temporal
fluent speech
preserved comprehension
no repetition
conduction aphasia
(Wernickes is disconnected from Brocas)
fluent speech
no comprehension
repetition impaired
Wernicke’s
[…] aphasias are characterized by preserved repetition
transcortical
needing assistance to sit on the exam table characterizes […] dementia
subcortical
decline in cognitive ability with intact consciousness
dementia
reversible causes of dementia [5]
depression
hypothyroidism
vitamin B12 deficiency
neurosyphilis
normal pressure hydrocephalus
strongest risk factor for AD
advanced age
Down syndrome patients have an increased risk of develop AD as the APP protein is located on chromosome
21
what neurotransmitter is decreased in AD?
ACh
how does APOE2 affect an individual’s chance of getting Alzheimer’s?
decreased risk of sporadic form
how does APOE4 affect an individual’s chance of getting Alzheimer’s?
increased risk of sporadic form
AD is characterized by widespread […] atrophy
cortical
(especially the hippocampus)
higher order language deficit
aphasia
motor inability to produce speech
dysarthia
[…] area is in the inferior frontal gyrus of the frontal lobe
Broca’s
associated with a defect in language production
Broca’s
patients with […] aphasia will appear frustrated, as insight is intact
Brocas
[…] area is in the superior temporal gyrus of the temporal lobe
Wernicke’s
[…] aphasia is associated with impaired language comprehension
wernicke’s
Do patients with Wernicke’s aphasia have insight?
No
Werknickes is Word salad
caused by damage to the arcuate fasiculus
conduction aphasia
hemispatial neglect syndrome indicates a lesion in the […]
nondominant parietal cortex
(agnosia of the contralateral side of the world)
agraphia, acalculia, finger agnosia, and left-right disorientation indicates a lesion where?
dominant (left) parietal cortex
a lesion in the frontal lobe can cause what symptoms
disinhibition
hyperphagia
impulsivity
loss of empathy
impaired executive function
akinetic mutism
(seen in frontotemporal dementia)
