Demential 2

Question 1

What is the histological finding that is the hallmark of Alzheimers Disease?

Answer 1

Neurofibrillary tangles

Amyloid Plaques

Question 2

The neuropathological hallmark of idiopathic Parkinsons Disease is Lewy bodies in what area of CNS?

Which area of the brain is depigmented?

Answer 2

Lewy bodies in neurons of the pars reticulata of the Substantia Nigra of brain stem.

Depigmentation of Substantia Nigra

Question 3

What is the mechanism of action for the following treatments for dementia?

Memantine?

Rivastigmine?
Donepezil?
Galantamine?

Answer 3

Mematine = NMDA antogonist (NMDA hyperstimulation is postulated to premature neuronal death due to influx of Ca2+. Memantine stops this)

Rest are Acetylcholinesterase inhibitors

Question 4

Wernkike’s Encephalopathy can present with ataxia, confusion, and eye movement problems …if it reversible with thiamine.

If untreated can progress to Korsakoff which presents with what irreversible symptoms?

Answer 4

1. Anterograde amnesia

2. Impaired memory

Question 5

Niacin deficiency (B3) or Pellagra presents with what triad?

Answer 5

1. Dementia
2. Dermatitis
3. Diarrhea

“3 Ds”

Question 6

The amyloid precursor protein gene, which is implicated in Alzheimers Disease, is found on which Chromosome?

How is APP gene implicated in Alzheimers?

Answer 6

Chromosome 21

Amyloid precursor protein is broken down into B-amyloid protein, which is a major component of senile plaques of Alzheimers.

Question 7

What is the diagnostic criteria of Major Neurocognitive Disorder?

Answer 7

SIGNIFICANT cognitive decine in 1 or more cognitive domains (executive function, memory, language, ext)

+

Interferes with functioning.

Question 8

What is the diagnostic criteria of Minor Neurocognitive Disorder?

Answer 8

MODEST cognitive decline in 1 or more domain

+

Does not significantly interfere with functioning.

Question 9

Major Neurocognitive Disorder has severity specifiers (unlike Mild NCD)…What would put someone in the Mild vs Moderate vs Severe?

Answer 9

Mild = difficulty in instrumental ADL (“SHAFT” Shopping, housekeeping, Accounting, Food prep, Transportation)

Moderate = difficulty with Basic ADS (“DEATH” Dressing, Eating, Ambulation, Toiling, Hygiene)

Severe = Fully dependent.

Question 10

What are the key differences between Major Neurocognitive Disorder vs Minor Neurogocnitive disorder?

Answer 10

Major NCD:

• Severe cognitive decline (1 or more cog domains)
• Impaired function
• Has severity specifiers (Mild, Moderate, severe)

Minor NCD:

• Modest cognitive decline (1 or more cog domains)
• function preserved (but with greater effort)
• No severity specifier