Norden - Alzheimer's

Question 1

Eliminates unnecessary synapses and helps to distribute synapses along dendrites into specific domains

Answer 1

Synapse elimination

Question 2

-_____ occurs from the third trimester through the first two years of life

Answer 2

Brain growth spurt

Question 3

What allows for the brain growth spurt (3rd trimester -> 2 years)

Answer 3

Increased size of neurons

Increased number and size of glial cells

Elaborate dendritication

Increase myelination of axons

Question 4

A progressive mental deterioration/decline

Answer 4

Dementia

Question 5

Most common causes of death in alzheimer’s patients

Answer 5

Infection / aspiration 2nd to pneumonia

Cerebral hemorrhage (amyloid proteins degenerate the vasculature of brain)

Question 6

Where is atrophy most pronounced in alzheimer’s brains?

Answer 6

Neocortical association cortex and in secondary motor and sensory areas of parietal temporal and frontal lobes

Question 7

The changes in memory in alzheimer’s disease are most likely due to neuron loss where?

Answer 7

Area 28
Hippocampus
Prefrontal cortex
Amygdala
Global loss in neocortex

Question 8

Loss of learned fear and emotional memory in Alzheimer’s patients comes from ?

Answer 8

Neurodegeneration in the amygdala

Question 9

Projects to the cortex w/o relay to thalamus. Main cholinergic input to cortex.

Degeneration always associated with dementia

Answer 9

Nucleus basalis of meynert

Question 10

This is possibly responsible for the decreased blood and glucose to the brain in alzheimers disease, because of its function to regulate cerebral blood flow in the cortex.

Answer 10

Nucleus locus coeruleus

Question 11

5HT, projections to neocortical areas especially frontal lobe. Degenerates in ALZ. Responsible for regulation of mood/ mood abnormalities assoc’d w alzheimers

Answer 11

Raphe nuclei

Question 12

What changes are seen on nissl stains in alzheimers neurons

Answer 12

Decreased neuronal body staining, likely due to decreased RNA.
Chromatolysis

Question 13

Silver stain shows what in Alzheimers brain?

Answer 13

Neurofibrillary tangle (NFT’s) which are intracellular twisted filaments

Question 14

What are neurfibrillary tangles comprised of ?

Answer 14

Paired helical filaments (phf)

These are insoludble, polymers of tau proteins, which are microtubule associated cytoskeletal proteins.

Question 15

What is different regarding tau anti body recognition in alzheimer’s patient’s ?

Answer 15

Tau antibodies usually recognize PHF’s, but in alz, these are hyperphosphorylated and not recognized by the antibodies

Question 16

NFT’s are located?

Answer 16

Intracellular

Question 17

Plaques are located ?

Answer 17

Extracellular

Question 18

What is seen in silver stains of neuropil areas ?

Answer 18

Plaques, extracellularly

Question 19

The diagnosis of alzheimers on autopsy is based on ?

Answer 19

Plaques/view/age

Question 20

Describe the structure that is plaques?

Answer 20

Core of beta-amyloid protein (insoluble) and microglia

In periphery; astrocytes ( which cause inflammation), swollen neurites, degenerating mitochondria, PHF’s, lysosomes, Apolipoprotein E

Question 21

Amyloid can replace the blood vessel wall and lead to leakage and hemorrhage. Contributes to decreased blood flow and can be why cerebrovascular hemorrhage is common in late alzheimers

Answer 21

Congophilic angiopathy

Question 22

What is believed to be the reason that there is decreased acetylcholine in alz pt’s.

Answer 22

Degeneration of the nucleus basilis of meynert and degen of integrative interneurons (golgi type II)

Question 23

What causes decreased norepinephrine in the cortex in alz pt’s

Answer 23

Nucleus coerules degradation

Question 24

What causes decreased 5HT in alzheimers?

Answer 24

Degeneration of the raphe nuclei

Question 25

Common early changes in Alzheimer’s disease are?

Answer 25

``` Memory loss (working and short-term) Decreased initiative (hobbies, self-hygiene) Depression Faulty judgement, loss of insight, other higher order functions. ```

Question 26

Why is the long term use of anti-psychotic drugs like haldol and clozapine contraindicated in alzheimer’s patients?

Answer 26

Increased risk of death | May be used acutely

Question 27

Why does deep brain stimulation of the fornix help reduce memory loss in alzheimers patients (early stage)

Answer 27

It stimulated the glucose metabolism in the brain and activates papez circuit

Question 28

What is early onset familial alzheimer’s disease?

Answer 28

Onset before 65 Autosomal dominant Chromosome 21, 14, 1

Question 29

In alzheimers there is a ___ and ____ of beta amyloid protein

Answer 29

Augmented release Failure of removal

Question 30

Leading theory for spontaneous alzheimer’s is that it is caused by ?

Answer 30

Neovascular issues

Question 31

When neuronal activity no longer working with blood supply

Answer 31

Neurovascular uncoupling

Question 32

What is the result of faulty beta-amyloid clearance, aborrhent angiogenesis, and age-related cerebrovascular changes ?

Answer 32

Neurovascular uncoupling, vessel regression, hypoperfusion of brain, inflammation Which lead to the eventual compromise of the blood brain barrier

Question 33

The nun study first recognized what?

Answer 33

The co-morbidity between alzheimer’s disease and cardiovascular disease

Question 34

In the nun study, which were the only nuns who developed alzheimer’s disease?

Answer 34

The ones who had suffered numerous brain microinfarctions

Question 35

The apoE allele is on which chromosome?

Answer 35

19

Question 36

inheritance of what allele (especially if both are this allele) is associated with increase risk of alzhemiers

Answer 36

ApoE4

Question 37

Individuals w/ E4/E4 show decreased rates of ______, even as young adults. These are the earliest changes identified in brain w increased alz risk

Answer 37

Glucose metabolism

Question 38

ApoE is ____ neurons under normal conditions

Answer 38

Not found

Question 39

ApoE binds _____ in extracellular space and may contribute to formation of mature plaques

Answer 39

Amyloid beta

Question 40

E4/E4 inheritance shows an increased difficulty in recovery from

Answer 40

Stroke or head injury

Question 41

Chronic stress kills neurons in the hippocampus via?

Answer 41

Cortisol binding

Question 42

Short term memory loss w/o other impairments

Answer 42

Mild cognitive impairment

Question 43

60-80-100% of patients with mild cognitive impairment go on to develop?

Answer 43

Alzheimer’s disease

Question 44

Factors shown to increase neurogenesis in adult/aging brain?

Answer 44

Enrichment Decreasing chronic stress Increasing physical exercise

Question 45

Prevents age-related neurogenesis in the brain. Helps maintain a healthy cardiovascular system, regulates blood glucose and weight, and decreases stress. Significantly decreases the risk for Alzheimer’s disease

Answer 45

Exercise