Nov. 25, 2019 Flashcards
During CORTICAL ATROPHY, what can be observed about the SULCI and GYRI?
The SULCI are more prominent and the GYRI are more slender
What role does the HIPPOCAMPUS play in cognitive Fx?
Maintains memory, important part in cognition
What role does the AMYGDALA play in cognitive Fx?
Helps to interact/respond to the intermediate environment
eg writing notes, listening to Ahmed
What happens to the HIPPO and AMYG when a pt has AD?
They lose NEURONS
Is the SENSORY CORTEX affected during AD?
No
What is the role of Ach?
It is a stimulatory NEUROTRANSITTER, that helps move APs from one neuron to another one
Are the lesions associated w AD visible to the naked-eye?
They are visible under a microscope
T or F:
NEURITIC PLAQUES are located inside the cell
F, they are located outside the cell
What is the core of a NEURITIC PLAQUE?
AMYLOID BETA w/ degenerative nerve terminals
How is ABETA formed?
ABETA is produced when AMYLOID PRECURSOR PROTEIN is broken down
What is the role of TAU proteins?
Proteins that stabilize microtubules
What are NEUROFIBRILLARY TANGLES composed of?
Primarily TAU
Where are NEUROFIBRILLARY TANGLES found?
They deposit inside of the cell’s cytoplasm, and at the end of fibers (I don’t know specifically what fibers, my notes just say “fibers”)
What do the deposits of TAU do to the fibers in brain cells?
They cause them to change shape and tangle, this is how they become NEUROFIBRILLARY TANGLES
Are TANGLES easy to breakdown?
No
TANGLES __________ after necrosis
Persist
What are the MNFTS of AD?
Anything r/t l/o cognitive Fx
Describe the onset of AD
Insidious
Approx how long do pts w/ AD live after diagnosis?
~ 10 yrs
T or F:
Death by AD is not directly a result of AD
T
How long does the mild stage of AD last?
2-4 years
How do the MNFTS of AD appear in mild AD?
- Pt appears mostly normal
- Can manage familiar tasks
- May become slightly negligent/forgetful
- If anyone realizes they’re sick, it will be the people around them, not the person themselves
How long does the mod stage of AD last?
2-10 years
How do the MNFTS of AD appear in mod AD?
- L/o cognitive Fx
- Substantial confusion
- Language problems
- Speaking and understanding
- May have repetitive speech
- Paraphasia (use of words in the wrong context)
- Poor self-care
- Depression
- Some aggression
How long does the severe stage of AD last?
~ 2 years
How do the MNFTS of AD appear in severe AD?
- Severe mental impairment
- No self-care
- Unable to respond to environment
- Minimal voluntary movement
- Flexor posturing
What does flexor posturing look like?
- Arms flexed, or bent inward on the chest
- Hands are clenched into fists
- Legs extended
- Feet turned inward
Is there a definitive test for AD?
No
How is the Dx of AD done?
- By excluding other possibilities eg dementia
- Imagining to detect lesions in the brain
- EEG
- CT
- MRI
- Labs to rule out other diseases
- B12
- HIV, syphilis
- CBC
- CRP
- Thyroid
What is the cure of AD?
There isn’t one
What is the Tx for AD?
- Suppress progression
- Symptom management
What drugs are involved in the management of AD?
- Ach-esterase inhibitor
- Aricept (Donepezil)
- Glutamine receptor blocker
- Memantine
- Anti-depressants
- Anti-psychotics
- Risperidone (Risperdal)
Which is normal to find in the body:
Myelinated or unmyelinated axons
Both!
What causes demyelination?
Autoimmune destruction of myelinated axons in the CNS
Who is most commonly affected by MS?
- Young women
- Residents of colder regions
- Caucasians
What is the Et of MS?
- Family Hx
- 15x more likely to have
- Abn MHC/HLA
- Complex trait
- Must have preceeding infct
- Viral trigger
- Often EBV (infctious mononeucleosis)
What is the effect of demyelination in the CNS?
Causes inflm damage -> poor conduction of AP
What are SCLEROTIC PATCHES in MS?
They are hardened patches produced when myelin in destroyed
What causes SCLEROTIC PATCHES?
Inflm damage caused by lymphocyte and macrophages
What is the usual role of OLIGODENDROCYTES?
They myelinate, and provide support to axons in the CNS
What areas are most affected by plaques?
- Optic nerve
- Spinal cord
- Cerebellum
- Brain stem
T or F:
Only motor response is affected in MS
F, bot motor and sensory are affected
What are the mnfts of MS?
- Sensory deficit
- Parasthesia
- Fatigue
- Uni-lateral visual impairment
- Bowel and bladder dysfx
- Weak muscle action
- Change in gait
- Chronic remissions and exacerbations
Is there a deficiency of ATP in MS?
No, the l/o voluntary muscle movement is all neuro related
How is MS Dx?
- Hx and mnfts
- MRI to view sclerotic patches
- Serology to dectect Abs
- Samples taken from the spinal cord
- CFS w inc IgE indicate MS
If protein content is elevated in CNS, what does this indicate? (3)
- BBB is compromised
- Autoimmune problem
- Inflm w/in spine or brain
Is MS reversible?
Nope
How fast is the progression of MS?
Not fast, slow progression
Why do you admin STEROIDS in MS?
- To suppress the immune response
- Suppress inflm
What can be used w STERIODS?
Interferons
What is METHOTREXATE? (this is involved in Tx for MS)
- An anti-CA agent
- Immunoregulatory (for longterm)
- Anti-folic
What is FOLIC ACID used for in the body?
- For cell division/DNA replication
- Hepatotoxic
- Standing orders for CBC and liver Fx
