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BIO37 > Midterm 2 General Deck > Flashcards

Midterm 2 General Deck Flashcards

1
Q

What is specific disorders (focal damage)?

A

The disorder depends on the area of of the brain affected (bullet wounds, strokes)

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2
Q

What is generalized disorders (widespread damage)?

A

The disorder affects multiple cognitive abilities(Closed head injury, dementing disorders, demyelinating diseases, toxic substances)

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3
Q

Aphasia

A

Lack of ability to understand or express SPEECH

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4
Q

Apraxia

A

Inability to link skilled MOTOR movements to ideas or representations

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5
Q

Agnosia

A

Deficit in recognizing OBJECTS that occurs in the absence of deficits in sensory processing

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6
Q

Acalculia

A

The inability to perform simple mathematic calculation the patient previously knew

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7
Q

Explain the types of dementias?

A

Cortical - co-occurance of many cognitive deficits including aphasia, apraxia, agnosia, acalculia, visuapatial defecits and memory problems (Alzheimer’s, Frontotemporal dementias)

Subcortical - More likely to manifest as personality changes, attention deficits, slowness in cognitive processing, difficulties with task requiring strategy (parkinsons, huntingtons)

Mixed - Vascular dementia, lewy body dementia. Mix of both

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8
Q

Alzheimer’s Dementia

A
  1. Impaired memory
  2. Impairment in at least one other cognitive domain
  3. Impairs social or occupational functioning
  4. Gradual onset and continual decline
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9
Q

Dementia With Lewy Bodies (DLB)

A

Presence of Lewy Bodies (alphasynuclein
neuronal inclusion bodies).
• Similar to AD in terms of cognitive
features and can sometimes be
confused with it, however it also
includes other symptoms e.g.
• Bradykinesia, rigidity (similar to Parkinson’s)
• Recurrent and well-formed hallucinations
• Memory deficits less severe than AD but visuospatial
deficits are more severe than AD.

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10
Q

Frontotemporal Dementia (FTD)

A 
No amnesia in the early stages
• Clinical syndrome associated with
shrinkage of the frontal and temporal
lobes
• Impulsive or bored and listless
• Inappropriate social behaviors
• Neglect of personal hygiene
• Repetitive or compulsive behavior
• Speech problems, semantic deficits
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11
Q

Vascular Dementia

A

Also known as MULTI-INFARCT DEMENTIA (MID)

Caused by blockages in the brain’s blood supply
• The second most common form of dementia (behind
Alzheimer’s)
• May cause or exacerbate Alzheimer’s (complicates
diagnosis as vascular factors contribute to AD).
• Cognitive Profile:
• More impaired than AD patients on executive function
• Less impaired on episodic memory

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12
Q

What are the risk factors if vascular dementia?

A 
High blood pressure (about 50%
can be caused by hypertension)
• Diabetes
• High cholesterol
• Family history of heart problems
• Obesity
• Smoking
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13
Q

Neuropathology

A

Degeneration of dopamine (DA) producing neurons in the brain (substantia nigra)

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14
Q

What are the motor symptoms of Parkinson’s disease?

A

*Tremor
• Bradykinesia
• Rigidity

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15
Q

What are the neuropsychiatric symptoms of Parkinson’s disease?

A 
Executive dysfunction
• Memory deficits
• Attention deficits
• Visuospatial deficits
• Mood disturbances
• Impulse control behaviors (e.g. food, drugs, gambling)
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16
Q

What are the Pharmacological treatment of Parkinson’s?

A

e.g. Levodopa
• Raise dopamine levels but will stop working eventually
as the cells producing dopamine will continue to
degenerate

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17
Q

What are the surgical treatment of Parkinson’s?

A
  • Deep brain stimulation (to stimulate dopamine
    production)
    • Lesions (to destroy the globus pallidus which is
    involved in motor control) - outcomes vary.
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18
Q

Amyloid Plaques?

A

Protein Aggregates

• Insoluble extracellular deposits
which accumulate in the cortex and
hippocampus.
• Composed of amyloid – beta (Aß)
protein fragments: Aß40 and Aß42.
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19
Q

Neurofibrillary Tangles

A

intracellular p-tau protein

* Bundles of insoluble helical fibers
within neurons.
• Composed of hyperphosphorylated
tau proteins that are normally
associated with microtubules.
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20
Q

What is the only clearly and reliably identified risk factor of AD?

A

ApoE4.
but it’s only a risk factor and does not
mean if you have it you will get the disease.

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21
Q

Tau Proteins

A

proteins that stabilize microtubules

microtubule-associated-proteins

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22
Q

What is a tauopathy?

A

A class of neurodegenerative diseases that is
associated with pathological aggregation of tau protein
in the brain.

  1. Alzheimer’s
  2. Chronic Traumatic encephalopathy
  3. Frontotemporal Lobar Degeneration
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23
Q

Chronic Traumatic Encephalopathy

A

Progressive degenerative disease occurring in those
with multiple concussions and head injuries.

e.g. athletes

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24
Q

What do three subtypes of Frontotemporal Lobar Degeneration share?

A

All share some common features
- à progressive decline in frontal
and temporal lobes.

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25
Q

What is affected in progressive nonfluent aphasia

A

• Broca’s area primarily affected – speech production

26
Q

Semantic Dementia

A

Loss of semantic knowledge

loss of word meanings

27
Q

Frontotemporal Dementia

A 
Begins in the frontal lobes
• Orbitofrontal cortex:
involved in emotional processing
• Right-sided damage first:
social behavioral impairments
• Left sided damage first:
language and semantic impairments
• Loss of the anterior cingulate, which
is critical for motivational behaviors
and conflict resolution
28
Q

Characteristics of Frontotemporal Dementia

A
  • Onset can be as early as twenties
  • Deficits in emotional processing
  • Deficits in behavioral and moral reasoning
  • Rather dramatic change early on in the disease
  • Inappropriate behaviors in public
  • Compulsive behaviors
  • Regression to child-like state of reasoning
  • Very difficult to diagnose
29
Q

PET scans in Alzheimer’s patients show reduced _____

A

Brain Glucose Metabolism

30
Q

Treatment for Alzheimer’s disease?

A

No treatment or cure.

31
Q

Symptomatic relief of alzheimer’s

A

Acetylcholinesterase inhibitors

NMDA receptor antagonist

32
Q

What are the risk factors for Alzheimer’s?

A

Age is the #1 risk factor for Alzheimer’s disease

• Genetics also plays a role: Known genetic basis (APP,
PS-1, and PS-2), but mostly for early-onset (familial) AD.

• ApoE4 is a reliably identified genetic risk factor for AD,
but it’s only a risk factor and does not mean if you have
it you will get the disease.

• Non-genetic factors that have associated risk include:
head trauma, high blood pressure, heart disease, stroke,
diabetes, and high cholesterol

33
Q

Prevention of Alzheimer’s

A

No evidence for prevention yet!
• Cognitive and psychosocial
activities may reduce risk for AD

• Phase III Prevention trial:
A4 Trial
(Anti-Amyloid Treatment in Asymptomatic AD)

• Physical activity linked to reduced
risk for AD in epidemiological studies

• Small benefits in clinical trials, most
notably in executive function

• Aerobic as well as strength training
show positive effects

  • Engaging in mentally stimulating
    activities such as reading

• Maintaining a larger social network

High educational level and
occupational attainment (high
cognitive reserve) associated with
decreased dementia incidence

34
Q

TRUE OR FALSE Adequate blood flow to the CNS must be

maintained at all times.

A

TRUE

35
Q

Why is the CNS sensitive to interruptions in blood flow?

A
  1. Unlike other tissues, cells of CNS can’t store
    glycogen and therefore must obtain glucose directly
    from blood.
  2. Most cells of CNS don’t have access to fatty acids
    for energy, which increase demands for glucose.
  3. CNS cells can’t obtain energy from anaerobic
    metabolism during periods of reduced oxygen
    availability, thus requiring uninterrupted oxygen and
    glucose support to stay alive.
36
Q

What is a stroke?

A

Brain tissue is damaged from a
sudden loss of blood flow, resulting
in a loss of neurological function.

37
Q

What are the types of stroke?

A
  1. Ischemic Stroke

2. Hemorrhagic Stroke

38
Q

Ischemic stroke

A

• Blockage inside a blood vessel
that deprives an area of the
brain from glucose and oxygen
• Embolic or thrombotic

Thrombotic – atherosclerotic plaque occludes an artery

Embolic – plaque or clot breaks off and blocks artery

39
Q

Hemorrhagic stroke

A

Bleeding into or around brain.

Weakened blood vessel ruptures

40
Q

Penumbra

A

is a zone of reversible ischemia around the
core of irreversible infarction – salvageable in the first
few hours after ischemic stroke onset.

41
Q

Transient Ischemic Attacks (TIAs)

A 
Stroke symptoms that resolve in
less than 24 hours
• Usually resolves in 15-20 mins
• More that 1/3 of people will go
on to have an actual stroke.
42
Q

Ischemic stroke: drug treatment

A

Only one FDA approved drug – TISSUE PLASMINOGEN
ACTIVATOR (tPA) which acts to breakdown clots and reintroduce
blood into an ischemic brain region.

43
Q

Major depression

A

A type of depressive disorder characterized by a depressed mood of at least two weeks in duration.

44
Q

Dysthymia

A

Chronic low-level depression.

45
Q

Bipolar disorders

A

A type of affective disorder characterized

by episodes of mania and depression that typically continue throughout a person’s lifetime.

46
Q

Cyclothymia

A

One of the bipolar disorders characterized by

less intense episodes of mania and depression than are seen in the bipolar disorder

47
Q

Hypomania

A

A milder form of mania in which occupational

or social functioning is not impaired.

48
Q

Depression - DSM Diagnosis

A 
Depressed mood or loss of interest in activities for more than
two weeks
• Deviates from the person’s baseline
(i.e. change from the norm)
• Impaired function: social,
occupational, educational
49
Q

Depression is associated with

A 
increased levels of stress
chemicals – cortisol
(gluccocorticoids in the brain).
• Gluccocorticoids reduce
dendritic spines necessary for
structural plasticity
50
Q

Stress affects the hippocampus

A

The hippocampus has a high concentration of gluccocorticoid
receptors à responsive to stress.
1. Reduces excitability (more difficult to learn)
2. Inhibits neurogenesis in the hippocampus
3. Retracts dendrites in the hippocampus.

51
Q

Mood Disorders: Brain Changes

A 
Reduced gray matter
volume in orbitofrontal
cortex, hippocampus,
amygdala, entorhinal cortex,
basal ganglia, and thalamic
nuclei.
52
Q

Mood disorders: PET studies

A

• PET scans reveal lower-than-normal activity during depressive
episodes and higher-than-normal activity during manic
episodes.
• In depression, the reduction is especially apparent in the left
frontal cortex.
• Decreased blood flow and metabolism have also been found
in the cingulate gyrus and the basal ganglia of depressed
individuals.

53
Q

In depression, what two regions in the prefrontal cortex (PFC) are dysfunctional?

A 
Ventromedial (vmPFC) is
hyperactive - associated with
generating negative emotion
and with self-reflection.
• Dorsolateral (dlPFC) is
hypoactive - associated with
reappraisal and suppression
of negative emotions.
• Functional imbalance in these regions leads to a negativity
bias and rumination of negative thoughts/memories.
54
Q

Risk factors and potential causes of depression

A
  • Genetics:
  • A family history of mood disorder may increase the risk
  • Twin studies indicate 40-50% heritability
  • Environment:
  • History of physical, emotional, or sexual abuse
  • Major life events e.g. death of a loved one, loss of a job
  • Other mental illness e.g. schizophrenia, anxiety
  • Other serious illnesses e.g. cancer, auto-immune disease
  • History of, or current substance abuse
55
Q

Nonpharmacological Treatments of depression

A
  1. Physical Exercise
  2. Mindfulness Based Cognitive Therapy (MBCT)
    3.
56
Q

Nonpharmacological Treatments of depression

A 
Electroconvulsive Therapy
• For drug-resistant depression
• Disadvantages
• High relapse rate
• Memory deficits
• A right unilateral ECT may work as well as a bilateral
application with fewer side effects.
A new promising alternative treatment is repetitive transcranial
magnetic stimulation (rTMS).
57
Q

Schizophrenia

A

A psychotic disorder involving
disturbance of thought, emotion,
and behavior

58
Q

Characteristics of Schizophrenia?

A
  • Broad Impairments
  • Thought disorder
  • Delusions
  • Hallucinations
  • Disorganized speech
  • Inappropriate emotions
  • Catatonia or immobility
  • Loss of touch with reality
59
Q

Positive Symptoms of Schizophrenia?

A
  1. Hallucinations
  2. Delusions
  3. Disorganized thoughts
60
Q

Negative Symptoms of Schizophrenia?

A
  1. Reduced speech (alogia)
  2. Lack of emotional and facial expression (affective flatening)
  3. Diminishing ability to begin and sustain activities (avolition)
  4. Decreased ability to find pleasure in everyday (anhedonia)
  5. Social withdrawal (asociality)

BIO37 (9 decks)

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