Dementia

Question 1

AD 3 Early Onset Genes and 2 Late Onset Genes

Answer 1

Early: APP (located on ch 21 so increased in Downs), presinilin 1 and 2
Late: ApoE4 increases risk, but E2 reduces it

Question 2

NT in AD

Answer 2

Decreased ACh

Question 3

2 Protein Deposits in AD

Answer 3

Senile plaques in gray matter: EXTRACELLULAR Beta-amyloid core, ABeta synthesized by cleaving Amyloid Precursor Prot (APP)

Question 4

Frontotemporal Dementia (sx, histo)

Answer 4

Characterized by change in personality to inappropriate behaviors early, maybe parkinsonian aspects. Also called Pick disease
Pick bodies: silver staining spherical tau protein aggregates

Question 5

Lewy body dementia (sx, histo)

Answer 5

Initially dementia and visual hallucinations, followed by parkinsonian features and repeated syncope
alpha-synuclein defect (Lewy bodies, mainly cortical

Question 6

2 Reversible Causes of Dementia

Answer 6

B12 def

Normal pressure hydrocephalus

Question 7

Memantine

Answer 7

NMDA R antagonist for AD, helps prevent excitotoxicity mediated by Ca++
SFX dizziness, confusion, hallucinations

Question 8

Main Category of AD Drugs (and 4 of them)

Answer 8

AChE inhibitors to increase ACh
Donepezil, galantamine, rivastigmine, tacrine
Nausea, dizziness, insomnia

Question 9

Delirium from Dementia

Answer 9

Delirium is more acute (hours/days/week) and “waxing and waning” level of consciousness. Less orientation and more hallucinations and stuff

Question 10

2 Most Common Causes of Delirium

Answer 10

Drugs and UTIs

Avoid anticholinergics for dementia in elderly because can add delirium. Also benzos