Confusional States Flashcards
What generally separates delirium from other confusional states?
typically has autonomic symptoms (dilated pupils, tachycardia, hyperthermia, increased sweating)
What percent of Alzheimer’s disease is sporadic? What is the life expectancy following the diagnoses of Alzheimer/s?
95%
usually progress to death in 7 to 10 years
What type of cortical atrophy is seen in Alzheimer’s?
general cortical atrophy, most pronounced in parietal and temporal lobes
What histologic features are seen in Alzheimer’s?
- Neurofibrilary tangles
- Senile Plaques
- Hirano’s bodies
What are neurofibrilary tangles?
intraneuronal inclusion
Paired helical filaments formed by hyperphosphorylation of microtubule- associated protein tau
What are senile plaques?
extracellular accumulation
Comprised of amyloid β peptides, proteolytic product of amyloid precursor protein (APP)
What are two scenarios that lead to increased accumulation of amyloid?
Trisomy 21 (Down’s syndrome)
ApoE4 mutation
APP is on what chromosome?
Ch 21
What are Hirano’s bodies?
intraneuronal inclusion
eosinophilic intracellular aggregates of actin and associated proteins in neurons
What neurotransmitter changes are seen in Alzheimer’s disease?
decreased ACh and increased glutamate
Name three AChEi.
donepizil, galantamine, rivastigmine
What histologic features are seen in Pick’s disease?
Pick’s bodies and Pick’s cells
What are Pick’s bodies?
intracellular inclusions of tau protein
What are Pick’s cells?
swollen neurons
What clinical picture typifies Lewy Body Disease?
alzheimer like patient with early onset hallucinations and parkinsonian features
What neurotransmitter changes are seen in Lewy Body Disease?
Loss of ACh and dopamine producing neurons
What histologic feature is characteristic of Lewy Body Disease?
a-synuclein cytoplasmic inclusions (Lewy Bodies)
What cerebral structure is affected in Wernicke-Korsakoff Syndrome?
atrophy of the mammillary bodies
