Delerium/dementia

Question 0

Risks associated with delirium

Answer 0

• dementia (10x)
• infection
• decline
• mortality

Question 1

Delirium

Answer 1

• disturbance of attention and wakefulness
• acute onset, limited duration
• confusion, altered perception, activity and sleep

Question 2

Causes of delirium

Answer 2

• alcohol withdrawal
• intoxication
• anti-everything
• antibiotics: ciproflaxin esp/ infections
• digitalis
• electrolyte imbalance/organ dysfunction
• neoplasm/trauma

Question 3

Depression vs. dementia

Answer 3

• biggest difference is deficits: depression exaggerates -> delirium minimizes
• effort in task also significant: depression doesn’t try, dementia struggles and fails

Question 4

Alzheimer’s etiology (4)

Answer 4

• 20s: trisomy 21 associated with Down’s syndrome
• 40s: pre-senilin 1 (ch P14), pre-senilin 2 (ch P1)
• 60-80s: ApoE (19)

Question 5

NF tangles/neuro plaques basics

Answer 5

• NF tangles: intracellular
  ~ Tau, MAP, ubiquitin
• plaques: intracellular
  ~ B amyloid (APP)

Question 6

Vascular dementia

Answer 6

• stepwise deterioration (doesn’t wax/wane)
• abrupt onset
• preservation of personality

Question 7

Alzheimer’s drugs (4) and natural history

Answer 7

• all drugs have initial improvement with gradual drop off
• central AChE inhibitors
  ~ Donepezil
  ~ galantamine
  ~ revastigmine
• memantine: cytoprotective adjunct
  ~ Glu channel blocker

Question 8

a-synuclean

Answer 8

• associated with Parkinson’s

Question 9

Pathenogenic cortical changes in Alzheimer’s

Answer 9

• primary temporal degeneration especially the hyppocampus

- NF plaques: Congo red core

Question 10

Pathenogenesis of plaques

Answer 10

• APP is normally cleaved by a-secretase then g-secretase
• in plaque formation B-secretase cleaves followed by g-secretase producing insoluble AB aggregates and leads for irregular phos of tau, and act of macs
• AB42 is pathenogenesis and insoluble

Question 11

Bodian silver stain

Answer 11

• granulovacuolar degeneration

- non-specific marker for AD

Question 12

Hirano bodies

Answer 12

• elongated glassy bodies in neurodegenerative process

- composed of actin

Question 13

Presenilins

Answer 13

• 1: chromosome 14
• 2: chromosome 1
• both associated with familial Alzheimer’s
• development of AD prior to age 50

Question 14

Lewy Bodies

Answer 14

• parkinsonian

- filamentous aggregations of a-synuclein