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PHRM 845 > L44 Patho and Pharm of AD > Flashcards

L44 Patho and Pharm of AD Flashcards

1
Q

T or F: There is a 2:1 ratio female:male for AD

A

True

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2
Q

5 sxs of AD

A
  • memory loss
  • impaired ability to learn, reason
  • impaired ability to carry out daily activites, confusion, untidiness
  • anxiety, suspicion, hallucination
  • motor dysfxn in late-stages
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3
Q

AD neuropathology: Loss of ______

A

brain volume, essentially brain shrinking

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4
Q

amyloid plaques (2 things)

A

extracellular
consist of amyloid-B peptide (AB)

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5
Q

neurofibrillary tangles (2 things)

A

intracellular
consist of hyper-phosphorylated tau

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6
Q

T or F: AD neuropathology primarily affects areas of high cognitive fxn

A

tru

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7
Q

Memory formation/consolidation:
a. entorhinal cortex
b. hippocampus
c. basal forebrain cholinergic systems
d. neocortex

A

a. entorhinal cortex
b. hippocampus

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8
Q

Learning (just learning):
a. entorhinal cortex
b. hippocampus
c. basal forebrain cholinergic systems
d. neocortex

A

c. basal forebrain cholinergic systems

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9
Q

Memory, learning, cognition:
a. entorhinal cortex
b. hippocampus
c. basal forebrain cholinergic systems
d. neocortex

A

d. neocortex

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10
Q

synapse loss leads to reduced levels of which neurotransmitters

A

ACh (mostly)
serotonin
norepinephrine
dopamine

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11
Q

what chromosome is the APP gene located on?

A

Chromosome 21

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12
Q

What is the AB peptide released from and by the activity of what two things

A

transmembrane amyloid precursor protein (APP), B-secretase (BACE1) and y-secretase

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13
Q

Mutations in the APP gene favor cleavage by what or what

A

B or y secretase

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14
Q

what does cleavage of APP by b or y-secretase result in?

A

production of more AB42 relative to AB40- **

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15
Q

what are two components of the y-secretase

A

Presenilin 1 and presenilin 2

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16
Q

what do PSEN1 and PSEN2 do

A

alter APP cleavage by y-secretase resulting in production of more AB42 compared to AB40

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17
Q

What does excessive phosphorylation of tau lead to?

A

neurofibrillary tangles

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18
Q

what leads to excessive phosphorylation of tau

A

release of cytokines from kinase activation after binding of Ab

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19
Q

what do neurofibrillary tangles do?

A

lead to the disruption of cytoskeleton and disrupts axonal trafficking

20
Q

what is tau’s normal function?

A

to stabilize microtubules

21
Q

what effect does AP aggregation have on microglia

A

triggers microglial activation to clear amyloid from the brain

22
Q

over-activated microglia is a feature of what

A

neurological diseases

23
Q

what do activated microglia release? What does this cause?

A

pro-inflammatory cytokines (prostaglandins, interleukins, tumor necrosis factor-a). causes neuroinflammation (no shit)

24
Q

activated microglia also release what and what? what does this cause

A

reactive nitrogen and oxygen species, causes oxidative stress (no shit again)

25
Q

Individuals with one or two of the following alleles have an increased risk of AD?
A. ApoE4
B. ApoE2

A

A. ApoE4

26
Q

Inheritance of which of the following alleles decreases AD risk?
A. ApoE4
B. ApoE2

A

B. ApoE2

27
Q

which of the following is protective?
A. ApoE4
B. ApoE2

A

B. ApoE2

28
Q

Which of the following statements is TRUE?

A. Aβ accumulation results in an inhibition of kinases that phosphorylate tau.
B. Interleukins contribute to synaptic loss in AD.
C. The presence of one or two ApoE2 alleles increases the risk of AD.
D. Synaptic degeneration in AD triggers a loss of acetylcholine but not dopamine.

A

B. Interleukins contribute to synaptic loss in AD.

29
Q

3 cholinesterase inhibitors

A

donepezil (Aricept)
Rivastigmine
Galantamine

30
Q

Specific, reversible inhibitor of acetylcholinesterase
A. donepezil (Aricept)
B. Rivastigmine
C. Galantamine

A

A. Donepezil (Aricept)

31
Q

Inhibits acetylcholinesterase and butyrylcholinesterase
A. Donepezil (Aricept)
B. Rivastigmine
C. Galantamine

A

B. Rivastigmine

32
Q

Selective, reversible inhibitor of acetylcholinesterase and enhances the action of ACh on nicotinic receptors (increases ACh release from cholinergic neurons)
A. Donepezil (Aricept)
B. Rivastigmine
C. Galantamine

A

C. Galantamine

33
Q

T or F: cholinesterase inhibitors treat symptoms of AD

A

True

34
Q

medication that falls under anti-glutamatergic therapy

A

memantine

35
Q

NMDA antagonist that blocks glutamatergic neurotransmission via a noncompetitive mechanism, reduces excitotoxicity
A. Donepezil (Aricept)
B. Rivastigmine
C. Galantamine
D. Memantine

A

D. Memantine

36
Q

what is the drug combo of Memantine ER + donepezil called?

A

Namzaric

37
Q

Radiolabeled agent specific for tau

A

F-FlorTAUcipir

37
Q

radiolabeled agent that binds B-amyloid, visualized by PET scanning

A

Florbetapir

38
Q

T or F: Pet scans are an effective way of observing amyloid in parkinsons

A

nah this is false dog its AD

39
Q

Impaired judgement or executive function is a more common initial sx than the memory loss characteristic of AD
A. Vascular Dementia
B. Dementia with Lewy Bodies
C. Frontotemporal Dementia (FTD) - e.g. pick’s disease

A

A. Vascular dementia

40
Q

Occurs as a result of brain injury associated with vascular disease or stroke.
A. Vascular Dementia
B. Dementia with Lewy Bodies
C. Frontotemporal Dementia (FTD) - e.g. pick’s disease

A

A. Vascular Dementia (duh)

41
Q

combination of cognitive decline and parkinsonian sxs.
A. Vascular Dementia
B. Dementia with Lewy Bodies
C. Frontotemporal Dementia (FTD) - e.g. pick’s disease

A

B. Dementia with Lewy Bodies

42
Q

visual hallucinations are a core diagnostic feature.
A. Vascular Dementia
B. Dementia with Lewy Bodies
C. Frontotemporal Dementia (FTD) - e.g. pick’s disease

A

B. Dementia with Lewy Bodies

43
Q

Disinhibited behavior, poor impulse control, antisocial behavior
A. Vascular Dementia
B. Dementia with Lewy Bodies
C. Frontotemporal Dementia (FTD) - e.g. pick’s disease

A

C. Frontotemporal Dementia (FTD) - e.g. pick’s disease

44
Q

tau accumulations
A. Vascular Dementia
B. Dementia with Lewy Bodies
C. Frontotemporal Dementia (FTD) - e.g. pick’s disease

A

C. Frontotemporal Dementia (FTD) - e.g. pick’s disease

45
Q

Which of the following statements is FALSE?

A. Donepezil is a more specific acetylcholinesterase inhibitor than rivastigmine.
B. Memantine interferes with Ca2+ accumulation in neurons exposed to glutamate.
C. Lewy bodies are a pathological hallmark of PD and DLB.
D. Small molecules that inhibit tau phosphatases are drug candidates for AD.

A

D. Small molecules that inhibit tau phosphatases are drug candidates for AD.

46
Q
A

PHRM 845 (34 decks)

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