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Pathophysiology > Dementia (week 10) > Flashcards

Dementia (week 10) Flashcards

1
Q

Dementia (definition)

A

progressive failure of many cerebral functions that is not caused by an impaired level of consciousness

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2
Q

characteristics of dementia

A
  • reduced cognitive function
  • impaired mental abilities
  • decreased ability to orient
  • decreased STM, followed by LTM
  • decreased language ability
  • impaired judgement
  • alterations of behavior
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3
Q

what occurs with dementia

A 
memory impairments
disorientation
hallucinations
illusions
delusions
confusion
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4
Q

what is the commonality of dementias

A

degeneration of neurons

atrophy of cerebral cortex and basal ganglia

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5
Q

classifications of dementia

A

cortical
subcortical
combination

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6
Q

types of cortical dementias

A

Alzheimer’s

Pick’s

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7
Q

types of subcortical dementias

A 
Parkinson's
Huntington's
Hydrocephalus
Endocrinopathies
Drug Intoxication
Heavy Metal Poisoning
Depression-Dementia Syndrome
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8
Q

Combination Dementias

A

Multiinfarct dementia
AIDS
Creutzfeldt-Jacob

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9
Q

factors that play a role in development of dementia

A

genetic predisposition
environment
behavior

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10
Q

testing for dementia

A 
lab testing (to r/o other causes)
neuropsychological exam
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11
Q

How is dementia treated

A

no cure, tx aims to slow the progression & maximize fxn

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12
Q

most common disease that interferes with cognitive ability in people over age 65

A

Alzheimer’s

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13
Q

Alzheimer’s accounts for __-__% of cases of late life dementia

A

50-60

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14
Q

what accounts for the other 40-50% of cases of late life dementia

A

anoxic and infarct

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15
Q

primary risk factor for Alzheimer’s

A

age; increases with each decade of age

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16
Q

What other diseases are associated with Alzheimer’s

A

Parkinson’s

Down’s Syndrome

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17
Q

What is found in post mortem Alzheimer’s brains

A
  • aggregation and precipitation of amyloid

- neurofibrillary tangles

18
Q

what makes up the neurofibrillary tangles

A

microtubules in nerve cells

19
Q

what are amyloid plaques composed of

A

A-beta peptides

20
Q

Amyloid cascade hypothesis for Alzheimer’s

A

there is an imbalance in production and removal of A-beta peptides in the brain that leads to accumulation and aggregation

21
Q

what is Amyloid

A

a lipoprotein

22
Q

where are neurofibrillary tangles primarily found in Alzheimer’s

A

hippocampus & cerebral cortex

23
Q

what are neurofibrillary tangles composed of

A

hyperphosphorlyated Tau protein that are unable to bind to microtubules allowing them to collapse

24
Q

how is the inflammatory response triggered in Alzheimer’s

A

accumulation of A-beta peptides is attacked by microglia, which sets up inflammatory process

25
Q

what is released during inflammatory response that is neurotoxic

A

cytokines
nitric acid
free radicals

26
Q

what drug class may serve protective function against Alzheimer’s

A

NSAIDs

27
Q

cholinergic hypothesis

A

significant loss of cholinergic neurons and nicotinic receptors in hippocampus and cortex thought to be secondary to the primary process of Alzheimer’s

28
Q

have attempts to increase ACh levels in the brain been successful?

A

no; ACh may not have been getting to the right part of the brain to help

29
Q

Other neurotransmitters that may contribute to Alzheimer’s

A
  • excitatory amino acids
  • increased activity of MAO-B
  • loss of serotonergic neurons
30
Q

how is LDL related to Alzheimer’s Disease

A
  • some LDLs are associated with increased deposition of A-beta peptides
  • AD is positively correlated with hypertension, increased LDL, and diabetes
31
Q

What vitamins may reduce risk of AD

A

E & C

32
Q

is vitamin E fat or water soluble?

A

fat (can be toxic)

33
Q

is vitamin C fat or water soluble

A

water (can cause kidney stones)

34
Q

How is estrogen associated to AD

A

estrogen may protect from AD

35
Q

what particular behavior changes are likely to be seen in AD

A

irritability
agitation
restlessness

36
Q

what types of imaging are used to diagnose AD

A

CAT
MRI
to check for shrinkage of sulci in cortex

37
Q

What serologic tests are performed to r/o other causes of AD

A 
blood cell counts
electrolytes
hepatic function
thyroid function
B12 levels
38
Q

what pharmaceuticals can induce symptoms of AD?

A 
sedatives and hypnotics
anticholinergics
opiates
antipsychotics
anticonvulsants
histamine receptor blockers
39
Q

what medications are used to treat AD

A
  • cholinesterase inhibitors for mild-moderate (improve cholinergic transmission)
  • glutamate receptor antagonist (Namenda) for moderate-severe
40
Q

what has been shown to decrease the likelihood of AD

A

exercise lifestyle

quality of brain (education, brain teasers, etc)

41
Q

what AD treatment is currently under investigation

A

immunotherapy to increase removal of A-beta peptides

Pathophysiology (19 decks)

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