DISEASE- Alzheimers, vascular, part of frontotemporal

Question 1

what is the commonest cause of dementia?

Answer 1

Alzheimers (50-70% of cases)

Question 2

chance of getting alzheimers if first degree relative has it?

Answer 2

if first degree relative has Alzheimers it doubles your risk

Question 3

what is classed as early onset and late onset alzheimers?

Answer 3

Early onset <65 years
Late onset >65 years

Question 4

what mutations are linked to early onset Alzheimers?

Answer 4

Rare autosomal dominant trait for early onset
-APP (alipoprotein) mutations (on chromosome 21)
-Presenilin 1 (chromosome 14)
-Presenilin 2 (chromosome 1)

Question 5

what genetic condition is Alzheimers linked with and why?

Answer 5

Link with Down syndrome (onset in 3rd or 4th decade)
-due to presence of APP gene present on chromosome 21 in down syndrome patients

Question 6

is Alzheimers more common in women or men?

Answer 6

more common in women

Question 7

what are some pathological hall marks of Alzheimers?

Answer 7

-Senile plaques (extra cellular protein deposits containing amyloid beta protein)
-Loss of cortical neurones
-Neurofibrillary tangles (tau aggregates)

Question 8

what colour does amyloid angiography stain?

Answer 8

Congo red

Question 9

What does the brain of someone with Alzheimers look like and what does this lead to?

Answer 9

Global brain atrophy (wide sulci, narrow gyri)
-leads to hydrocephalus ex vacuo and compensatory increase in ventricle size

Question 10

management of Alzheimers?

Answer 10

1st= cholinesterase inhibitors (rivastigmine, galantamine, donepezil)

2nd= NMDA receptor blocker (memantine)

Question 11

example of chokinesterase inhibitors?

Answer 11

-rivastigmine
-galantamine
-donepezil

Question 12

vascular dementia- what?

Answer 12

dementia caused by widespread small vessel disease within brain due to hypertension or diabetes, leading to extensive and diffuse damage to the subcortical white matte

Question 13

who is more likely to get vascular dementia?

Answer 13

M>W
>60
People with hypertension or pre existing vascular disease

Question 14

what is the core criteria for diagnosing vascular dementia?

Answer 14

1. Presence of vascular disease
   AND
2. A clear temporal relationship between the onset of dementia and cerebrovascular disease

Question 15

management of vascular disease?

Answer 15

Treat vascular risk factors
+/- cholinesterase inhibitors (rivastigmine, galantamine, donepezil)

Question 16

what is frontotemporal dementia?

Answer 16

-an early onset type of dementia where there is neurodegenerative proteinopathy (usually tau)