Neuro 1 pt8 (afternoon)

Question 1

Most common dementia and second most common neurodegenerative d/o.

Answer 1

Alzheimer’s Ds

Question 2

Histologic Hallmarks of Alzheimer’s = (2)

Answer 2

neurofibrillary tangles

and amyloid plaques

Question 3

What part of the brain is where alzheimers affects patients? Why?

Answer 3

Hippocampus, b/c it is very important for memory

Question 4

What does the hippocampus look like?

What’s a unique feature of it?

Answer 4

“sea horse”

new neurons are continuously created, thus, has some regenerative quality.

Question 5

PET scan of normal brain compared to alzheimer’s ds brain shows there is a decreased ___ activity in Alzheimer’s

Answer 5

Decreased mitochondrial activity

Question 6

type of drug for symptomatic tx of Alzheimer’s

Answer 6

Cholinesterase inhibitors

Question 7

3 cholinesterase inhibitors against Alzheimers (3 FDA approved drugs to treat Alzheimers)

Answer 7

Donepezil
Galantamine
Rivastigmine

Question 8

small infarcts caused by blood not making it to furthest areas of the brain

Answer 8

Binswanger’s disease

Question 9

Dementia associated with cerebrovascular disease can be divided into two general categories:

Answer 9

multi-infarct dementia and diffuse white matter disease (Binswanger’s disease)

Question 10

Axial fluid-attenuated inversion recovery (FLAIR) MR image through the lateral ventricles reveals multiple areas of hyperintensity involving the periventricular white matter

Answer 10

diffuse white matter disease (Binswanger’s disease)

Question 11

CADASIL stands for

Answer 11

Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy

Question 12

A dominantly inherited form of diffuse white matter disease
Clinically, there is a progressive dementia developing in the fifth to seventh decades in multiple family members who may also have a history of migraine and recurrent lacunar stroke without hypertension. Skin biopsy may show pathognomonic osmophilic granules in the media of arterioles

Answer 12

CADASIL

Question 13

How to treat Vascular Dementia

Multi-Infarct, Binswanger’s, CADASIL

Answer 13

for Multi-Infarct & Binswangers: tx the cause (htn, carotid stenosis)
CADASIL has no tx

Question 14

The ___ clinical syndrome is characterized by visual hallucinations, parkinsonism, fluctuating alertness, falls, and often RBD.

Answer 14

DLB - Lewy Body Dementia

Question 15

what is parkinsonism?

Answer 15

similar to Parkinson’s disease, but it is caused by certain medicines, a different nervous system disorder, or another illness

Question 16

What is RBD? (a symptom of DLB)

Answer 16

REM behavior disorder - kicking, screaming, jumping out of bed

Question 17

If dementia comes after parkinsonism: ___; both DLB & PDD are considered to be two points on a spectrum

Answer 17

PDD (Parkinson’s Disease Dementia)

Question 18

Define PDD

Answer 18

Parkinson’s Disease Dementia -

Question 19

unlike early AD, relative preservation of memory, but more severe visuospatial and executive deficits is found with:

Answer 19

DLB

Question 20

begins 50s-70s (similar prevalence to AD @ that age)
impaired executive, judgement & language
behavioral symptoms predominate: apathy/no empathy, disinhibition, wt.gain/food fetishes, compulsions
Absence of insight to their condition
Spared memory, visuocontructive ability, arithmetic, navigation

Answer 20

Frontotemporal Dementia (FTD)

Question 21

2 areas/categorizations of FTD (Frontotemperal Dementia)

Answer 21

Nonfluent: Broca’s area
Logopedic: Wernicke’s area

Question 22

progressive fatal neurodegenerative dz of brainstem, BG, limbic area, some cortex

Answer 22

Progressive Supranuclear Palsy (PSP)

Question 23

2 key parts of recognizing Progressive Supranuclear Palsy

Answer 23

oculoparesis (especially downgaze)

devel.symmetrical rigid bradykinesia c hyperext.of neck; resulting in unstable posture/jerky toppling gait and falls