Neuropathology of Dementia

Question 1

neurodegenerative diseases affecting the cortex

Answer 1

Alzheimers

frontotemporal dementia

Question 2

neurodegnertaive diseases affecting the basal ganglia causing movement disorders

Answer 2

Parkinson disease

Huntington disease

Question 3

neurodegenerative diseases affecting the Cerebellum and spinal cord

Answer 3

ataxia 


Question 4

4 Protein accumulation and inclusions in neurodegenerative diseases

Answer 4

• β-Amyloid
• Tau
• Alpha-synuclein
• TDP-43

Question 5

4 reasons for alzheimers

Answer 5

• Protein accumulation and inclusions - β-Amyloid,Tau,Alpha-synuclein,TDP-43
• Reaction (inflammation)
• Unremitting progression
• Unknown or genetic cause

Question 6

list the differential diagnoses for memory loss

Answer 6

• Alzheimer Disease

• Vascular Disease

• Drugs, Depression, Delirium
• 
Ethanol

• Metabolic
Endocrine (thyroid, diabetes)

• Neurologic (other dementia’s e.g Lewy body dementia)
• Tumour, Toxin, Trauma

• Infection

• Autoimmune

AVDEMENTIA

Question 7

what is delirium

Answer 7

• Acute onset
• Fluctuating conscious level secondary to underlying medical condition
• Disordered thinking
• Visual/tacile hallucinations Illusions

Question 8

what is dementia

Answer 8

• Progressive
• No alteration in consciousness
• Primary CNS disease
• Lack of insight
• Memory impairment
• Cognitive impairment

Question 9

who mainly gets frontotemporal dementia

Answer 9

Younger patients: 45-65 year olds

Question 10

what is frontotemporal dementia

Answer 10

• Sporadic/inherited
• Frontal lobedys function–behavioural/personality changes, disinhibition, depression, agitation
• Cognitive and memory impairment
• Tau accumulation causing Pick’s bodies - Pick’s disease 


Question 11

what is vascular dementia

Answer 11

• Underlying vascular pathology
• Hypertensive
• Vascular risk factors

Question 12

reversible causes of dementia

Answer 12

• Hypothyroidism Nor
• mal pressure hydrocephalus
• Drugs(opiates, sedatives, anticholinergics)
• Tumours(eg meningioma)
• Neurosyphilis
• Chronic subdural haematoma
• Whipple’s disease
• Nutritional eg: Pellagra (VitB3 deficiency)
• Psychiatric disorders

Question 13

Cognitive decline and dementia do not represent

Answer 13

normal ageing

Question 14

effects of predominantly frontal dementia

Answer 14

prominent behavioural alteration

Question 15

effects of predominantly occipital dementia

Answer 15

prominent visuospatial alteration

Question 16

where is Alzheimers first noticed

Answer 16

entorhinal cortex, then the hippocampus.

Question 17

effect of normal aging on memory

Answer 17

Increase in forgetfulness after age 50

Slowing of response times

Physical Changes (vision, hearing, sensory/motor impairment)

Question 18

features of Dementia

Answer 18

• Impaired short and long term memory
• Impairment of intellectual ability
• Multiple cognitive domains
• Personality changes
• Interferes with ADLs/ social interactions
• Consciousness preserved

Question 19

clinical effect and Primary LB pathology of Parkinsons disease

Answer 19

Extrapyramidal movement disorder

Nigrostriatal system

Question 20

clinical effect and Primary LB pathology of dementia with levy body dementia

Answer 20

Dementia

Cerebral cortex

Question 21

normal weight of the human brain

Answer 21

200-1400g

Question 22

weight of Alzheimers brain

Answer 22

950g

Question 23

features of Macroscopic examination of Alzheimers brain

Answer 23

• less weight
• Thinned neocortical ribbon
• Loss of white matter
• Cortical atrophy
• Sulcal widening and gyral atrophy

Question 24

features of Macroscopic examination of Vascular dementia brain

Answer 24

• Weight 1320g
• No significant fronto-temporal atrophy
• Mild/mod basal vessel atheroma
• Multiple areas of cystic disruption throughout cortex
• Mild ventriculomegaly 


Question 25

disease with Pallor of brainstem pigmented nuclei

Answer 25

Parkinson’s disease

Question 26

main risk factors for dementia

Answer 26

* Increasing age * Genetics (APP, Presenilin, APOE4) * Downs syndrome * Female gender (2/3 with dementia are female) * Head injury

Question 27

where does Vascular dementia Small vessel disease effect

Answer 27

subcortical

Question 28

where does where does Vascular dementia large vessel disease effect

Answer 28

cortical multi-infarcts 


Question 29

3 features of Vascular dementia

Answer 29

Stepwise progression Memory impairment Lack of insight 


Question 30

dementia with Insidious onset and a Clear history of worsening

Answer 30

dementia due to Alzheimers disease

Question 31

Amnestic and Non amnestic symptoms of dementia due to Alzheimers disease

Answer 31

**Amnestic** episodic memory alteration **Non amnestic** Progressive aphasia Visuospatial deficit Executive dysfunction

Question 32

features of dementia with levy bodies

Answer 32

* Progressive cognitive decline * Fluctuating consciousness * Visual hallucinations * Parkinsonism * Similar features to AD and PD * Pallor of brainstem pigmented nuclei * Cortical Lewy bodies

Question 33

symptoms of Mild AD

Answer 33

memory loss confusion trouble handling money poor judgment mood changes anxiety

Question 34

symptoms of moderate AD

Answer 34

* increased memory loss and confusion * problems recognizing people * difficulty with language and thoughts * restlessness * agitation * wandering * repetitive statements.

Question 35

most common cause of Alzheimers death

Answer 35

pneumonia.

Question 36

how does Alzheimers affect the brain

Answer 36

* Affected regions begin to atrophy with associated neuronal loss * AD spreads through the brain * The cerebral cortex begins to atrophy with more neuronal loss * Severe cortical atrophy * Pathology throughout the neocortex.

Question 37

Answer 37

Question 38

Answer 38