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Control Term Two > Dementia > Flashcards

Dementia Flashcards

1
Q

Frontal lobe damage

A

Impaired judgement, abstract reasoning, strategic planning, emotional restraint, control of appetite and continence

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2
Q

Medial temporal lobe damage - hippocampus, amygdala, limbic - damage

A

Memory disorders

Hallucinations

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3
Q

Temporal neocortex damage

A

Receptive dysphasia and automatisms

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4
Q

Occipital lobe damage

A

Failure of visual sensory systems

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5
Q

Parietal lobe damage

A

Impairment of visuospatial skills, integration of sensory inputs, leading to sensory agnosias and apraxias

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6
Q

Neurodegenerative dementia types

A 
Alzheimer's
Lewy body dementia
Frontotemporal dementia
Huntington's disease + many others
Vascular dementia
Prion diseases
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7
Q

Dementia classification categories

A

Ant/post

Cortical/subcortical

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8
Q

Movement disorders examples

A

Parkinson’s
Parkinson plus syndromes
Huntington’s disease
Motor neuron disease

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9
Q

Neurodegenerative dementias

A

Alzheimer’s
Frontotemporal dementia
Dementia with lewy bodies

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10
Q

Tauopathies

A

Frontotemporal dementia

Alzheimer’s

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11
Q

Ubiquinopathies

A

Frontotemporal dementia

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12
Q

Synucleinopathies

A

Parkinson’s
Dementia with lewy bodies
MSA

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13
Q

Normal pressure hydrocephalus - presentation

A

Triad of: dementia, gait disturbance, urinary incontinence

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14
Q

Normal pressure hydrocephalus - types

A

NPH with preceding cause e.g. SAH, meningitis, trauma, radiation-induced

Idiopathic (50%)

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15
Q

What would show triphasic waves?

A

Transmissible spongiform encephalopathies

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16
Q

What does CBD stand for?

A

Corticobasal degeneration

17
Q

What is CBD?

A

Tauopathy

MRI shows phospho-tau filaments within the neuron from a brain of CBD

18
Q

What does VGKC Ab mean?

A

Voltage gated potassium antibodies

19
Q

What does VGKC Ab indicate and present?

A 
Subacute memory loss
Psychiatric/behavioural disturbance 
Seizures
Hyponatraemia
65 yo median age; 2:1 M:F
Immunomodulation for treatment - if no tumours but a lot have tumours
20
Q

What proteins are involved in dementia

A

B-amyloiad
Tau
a-synclein
Ubiquitin

21
Q

What are amyloid proteins?

A

INsoluble fibrous protein aggregates sharing specific structural traits

22
Q

What do tau proteins do?

A

A group of proteins that stabilise microtubules in neurons

Six isoforms - if defective, microtubules become unstable and dysfunctional

23
Q

Amyloid cascade model

A
  1. a-secretase processing of APP is modulated by stimulation of ACh or 5HT receptors.
  2. Within the neuron, PS1 associated with APP and traffics it with an endosomal vesicle, generating AB1-42
  3. AB1-42 secreted and forms aggregates
  4. activate microglia + react excitotoxically with neurons, forming plaques via interaction with ApoE and deposition of AB amyloid as plaque
  5. Plaque formation degenerates neurons
  6. Active microglia make positive feedback loop + enhances plaque
24
Q

a-Synuclein pathway

A
  1. Monomer folds badly
  2. forms b-sheet oligomer
  3. Forms lewy body
25
Q

What is ubiquitin?

A

Small regulatory protein in almost all cells
Directs proteins to cell compartments
Can be attached to protein and label them for destruction

26
Q

Pathogenesis

A
  1. Oxidative stress makes free radicals
  2. Excitotoxicity: glutamine stimulation
  3. Induction of apoptosis

Cytokines, genetic factors, ageing and unknown aetiology

27
Q

Accumulation of abnormal proteins intracellular

A

Tau
a-Synuclein
Polyglutamine
Ubiquitin

28
Q

Accumulation of abnormal proteins extracellular

A

Amyloid

29
Q

Macroscopic neuropathological findings of AD

A

Brain weight decrease - (1300 -> 1000)
Atrophy in cerebral gyri (hippo, temp, parietal, frontal, cingulate - less so occipital)
Atrophy in white matter + thin corpus callosum + brain stem + cerebellum
Ventricular dilatation
Pale substantia nigra + locus ceruleus

30
Q

Microscopic neuropathological findings of AD

A

Neuron loss from hippo,cerebral cortex
Microvacuolation in cerebral neocortex
Attenuation in white matter

31
Q

Braak staging system what is it?

A

Shows mild to severe infiltration of abnormal proteins

32
Q

Names of CERAD groups

A

Normal
Definitive AD
Probable AD
Possible AD

33
Q

Macroscopic finding of dementia with lewy body (DLB)

A

Pale substantial nigra and LC???

Atrophy in amygdala, cingulate, temp, parietal, frontal

34
Q

Microscopic finding of dementia with lewy body (DLB)

A

Neuronal loss from SN and LC

Accumulation of a-synuclein +ve bodies in neurons of SN, amygdala and later in the cerebral cortex

35
Q

DLB under microscope you see

A

Red bodies

36
Q

Vascular dementia features

A

Multi-infarct dementia (ischaemic damage to brain)
Binswanger’s dementia (pathology mainly in white matter - microinfarctions in white matter)
Arteriolosclerosis (high pressure and become sclerotic, collagen fibres replace smooth muscle, less able to supply local region so loss of neurons)

37
Q

Frontotemporal dementia (pick’s disease) under microscope

A

Balloon cells and pick bodies - ubiquitin and tau positive

38
Q

Abbreviations of major neuropathological diagnosis of dementias

A 
Alzheimer’s Disease (AD)
Frontotemporal lobar degeneration (FTLD)
Dementia with Parkinsonism:
Idiopathic Parkinson Disease (IPD)
Dementia with Lewy Body (DLB)
Corticobasal degeneration (CBD)
Progressive Supranuclear Palsy (PSP)
Vascular Dementia (VaD)
Normal Pressure Hydrocephalus (NPH)
Creutzfeldt-Jakob Disease (CJD)

Control Term Two (25 decks)

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