Dementia Flashcards
What genetic defects are associated with early onset Alzheimers disease? What chromosomes
APP (chromosome 21), presenilin-1 (chromosme 14), and presinilin 2 (Chromosome 1)
What genetic defects are associated with late on set Alzhemiers?
ApoE4 (chromosome 19)
What genes are protective against Alzheimer?
ApoE2
What are the extracellular pathologic/histo changes associated with Alzheimer?
senile plaques: extracellular beta amyloid core that may cause amyloid angiopathy
this can lead to intracranial hemorrhage.
amyloid beta is synthesized by cleavage of the APP (amyloid precursor protein)
What are the intracellular pathologic/histo changes associated with Alzheimer?
neurofibrillary tangles: intracellular, hyperphosphorylated tau protein. this is made of cytoskeletal elements; tangles correlate with the degree of dementia
What are key features of pick disease?
dementia, aphasia, parkinsonian aspects with a change in personality. spares the parietal lobe and posterior 2/3 of superior temporal gyrus
What are pick bodies?
spherical tan protein aggregates with frontotemporal atrophy.
What histologic features are associated with lewy body dementia?
alpha-synuclein defect
What are the symptoms of creutzfeldt-jakob disease?
rapidly progressive (weeks to months) dementia with myoclonus)
What pathology would be seen in creutzfeldt jakob disease?
spongiform cortex see prions (PrP c to PtP sc sheet- this is a beta pleated sheet resistant to proteases
What vitamin deficiencies can cause dementia?
B1, B3, or B12
What are the drugs available for Alzheimer disease?
memantine; donepezil, galantamine, rivastigmine
How does memantine work? what would you see with an overdose?
NMDA receptor antagonist (glutamate receptor antagonist). this helps prevent excitotoxicity medaited by Ca2+.
causes dizziness, confusion, and hallucinations if overdosed.
How do donepezil, galantamine, and rivastigmine work? Toxcity?
AChE inhibitors.
toxicity: nausea, dizziness, insomnia
