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Dementias and stroke > Dementias and Stroke > Flashcards

Dementias and Stroke Flashcards

1
Q

a descriptive term for a collection of
symptoms that can be caused by a number of
disorders that affect the brain

A

Dementias

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2
Q

how is dementia diagnosed

A

Dementia is diagnosed only if two or more brain
functions - memory, language skills, perception, or
cognitive skills (reasoning and judgment) - are
significantly impaired without loss of consciousness.

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3
Q

Memory loss is a common symptom, but memory

loss by itself does not indicate dementia (T/F)

A

True

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4
Q

a progressive neurodegenerative
disorder in which decline of general cognitive
function occurs, usually accompanied by
affective and behavioral disturbances.

A

AD

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5
Q

cause for dementia

A

Some cases have a familial (genetic) basis,
but the great majority (90%) appear to be
sporadic

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6
Q

patients with AD live for ______
years after they are diagnosed. Patients with
AD often die of _____ _____ because
they lose the ability to swallow late in the
course of the disease.

A

8 to 10

aspiration pneumonia

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7
Q

The key neuropathological elements of AD (macroscopic)

A

gross atrophy of the

brain

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8
Q

The key neuropathological elements of AD (microscopic)

A 
amyloid plaques,
neurofibrillary tangles
extensive neuronal loss in the neocortex,
hippocampus, and other subcortical
regions of the brain.
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9
Q

accumulations of aggregated molecules in the extracellular

space of the brain

A

Amyloid plaques

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10
Q

The principal proteinaceous component of plaques is the

A

amyliod-beta peptide

A-beta

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11
Q

amyliod-beta peptide

A beta

A

a 38– to 43–amino acid peptide derived from a much larger protein, the
amyloid precursor protein, APP

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12
Q

tends to spontaneously self-aggregate into multiple coexisting physical forms

A

alpha beta

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13
Q

A-beta peptide is produced from much larger transmembrane protein, the amyloid precursor
protein, ____. The exact physiological function of
APP is unknown.

A

APP

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14
Q

The toxic A peptide is produced from the transmembrane protein APP via cleavage by two enzymes:

A

beta-secretase and gamma-secretase

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15
Q

Excess production of A is a key initiator of cellular damage in ___

A

AD

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16
Q

______ tangles are found in the cytoplasm of neurons

A

Neurofibrillary tangles (NFTs)

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17
Q 
The NFTs (Neurofibrillary tangles) are composed of highly stable polymers of cytoplasmic proteins
called
A

TAU

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18
Q

proteins possess microtubule-binding domains and help to stabilize
microtubules.

A

TAU

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19
Q

•In AD, tau proteins become highly phosphorylated and as a result, dissociate
from ________ and polymerize into filaments forming NFTs.
•The microtubules disintegrate in the process, leading to disruption of
______- transport and subsequent neuronal death.

A

microtubules

axoplasmic

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20
Q

Genetics of AD occur in mutations of chromosomes :

A

mutations on

chromosomes 21, 14, and 1.

21
Q

Mutations on chromosome 21
cause the formation of abnormal
____ ____ _______

A

amyloid precursor protein (APP).

22
Q 
Mutations on chromosome \_\_\_  and
\_\_ cause formation of abnormal
presenilin proteins (prenesilin
proteins are structural subunits of
gamma-secretase complex)
A

14

1

23
Q

In about 50% of late-onset AD (60 and older) patients, __ isoform of ____
has been identified as a risk factor

A

E4

apoE4

24
Q

there three major isoforms ___, ___, ___, which arise from

different alleles __, ___, ___ of a single gene on chromosome 19.

A

(apoE2, apoE3, and apoE4)

E2, E3, and E4

25
Q

The ___ allele is associated with increased risk and earlier onset of late-onset AD,
inheritance of __ allele is associated with decreased risk and later onset

A

E4

E2

26
Q

Treatment of AD (what 2 drugs)

A

-Cholinesterase inhibitors
-Memantine-NMDA receptors
modulator

27
Q

The second most common type of dementia

May appear soon after a single major stroke that
disrupts the blood supply to a significant portion of
the brain (“post-stroke dementia”)

A

vascular dementia

28
Q

symptoms of vascular dementia

A

vary depending on the affected brain
areas:
-with sudden decline function, rather than the slow, steady decline

29
Q

underlying causes of vascular dementia

A

hypertension, diabetes, smoking, or

lack of exercise

30
Q

characterized by the sudden onset of a focal
neurologic deficit due to an abnormality of the cerebral circulation, such as
blockage or rupture of the blood vessel, supplying the brain.

-third leading cause of death in the United States

A

Stroke

31
Q

•Significant risk factors of stroke (6)

A 
hypertension
hypercholesterolemia
diabetes
smoking
heavy alcohol consumption
oral contraceptive use
32
Q

Strokes may be classified into two major categories based on

pathogenesis:

A

ischemic stroke and hemorrhagic stroke

33
Q

•In ______ stroke, vascular occlusion interrupts blood flow to a specific
brain region, producing a fairly characteristic pattern of neurologic
deficits

A

ischemic

34
Q

Thrombus may form in an artery that is already very narrow. If it
completely blocks the artery, it is called

A

thrombotic stroke

35
Q

Thrombus may break off from another place in the blood vessels of the
brain, or some other part of the body, and travel up to the brain to block a
smaller artery. It causes

A

embolic stroke

36
Q

______ stoke occurs upon rapture of a weakened blood vessel in the brain. pattern of deficit depends on the location of the bleeding

A

•Hemorrhagic strokes

37
Q

Drugs use to treat ischemic strokes (3)

A
  • Thrombolytic agents
  • Anticoagulants
  • Aspirin
38
Q

these agent must be administered in the hyperacute phase of stroke (<4.5 hours after
onset).

A

Thrombolytic agents

39
Q

_____ reduces the risk of serious vascular events in high-risk patients (e.g., those
with previous myocardial infarction) by 20-25%.

A

Aspirin

40
Q

•Low-dose (<100 mg/day) aspirin, is relatively (but not exclusively) selective for _____,
and is associated with a lower risk for GI adverse events

A

COX-1

41
Q

aspirin approximately doubles the mean bleeding time in healthy person for 4-7 days.
This effect is due to irreversible acetylation of platelet ____

A

COX

42
Q

Hemorrhagic stroke treatment

A

Treatment usually involves
attempting to control high
blood pressure, bleeding, and
brain swelling.

43
Q 
Thrombolytics are not given to
someone who is having a
\_\_\_\_\_ stroke. They could
worsen the stroke by causing
increased bleeding.
A

hemorrhagic

44
Q

these drugs were withdrawn from the

market to cardiovascular toxicity

A

•COX-2 selective inhibitors

45
Q

currently is the only COX-2 inhibitor

licensed for use in the U.S.

A

Celecoxib

CELEBREX

46
Q

_____ ____related to drug use promotes
damage of cerebral arterioles, which may eventually
rupture, resulting in stroke

A

•Acute hypertension

47
Q

amphetamines, over the
counter sympathomimetics (acute hypertension drugs) increase ______
release

A

catecholamine

48
Q

may cause spontaneous subclinical
hemorrhages that eventually become clinically
significant through their anti-platelet effects (4)

A

Thrombolytic agents
aspirin
anticoagulants
SSRI

49
Q

can induce acute hypertension and increase the risk of stroke (3)

A

Caffeine
cigarette smoking
alcohol abuse

Dementias and stroke (1 decks)

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