Path XI Flashcards

1
Q

most common dementia

A

alzheimer disease

onset >65 yrs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Signs Sx alzheimer

A
slowly progressive memory dysfunction
dysphagia and dyspraxia
prgression to akynetic mutism
confusion with time and place
misplacing objects
decreasing judgement
social withdrawal
mood personality changes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

alzheimer assoc with

A

some familial
some downs
most sporadic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

type of atrophy in alzheimer

A

cortical atrophy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

amyloid plaques appear where in alzheimers

A

outside of neuron

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

where does tau collect in alzheimer

A

inside neuron

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what enzyme is problem in collection of plaques and tau proteins in alzheimers

A

beta amyloid converting enzyme
or
beta secretase cleavage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

most cases of alzeimers disease are

A

spontaneous

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

mutations with familial alzheimers

A

beta amyloid precursor protein 21q21 (downs region)

presenilin— early onset AD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

mutation of presenilin or beta amyloid precursor protein increase what

A

beta amyloid precursor protein

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what apo protein is associated with alzheimers

A

ApoE epsilon4 form
increase 25% for late onset AD
promotes beta amyloid precursor protein formation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

tau protein encoded where

A

17q21.1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

plaques in neurites with amyloid cores

A

alzheimers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

role of tau

A

stabilizes microtubules

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

most common initial Sx of alzheimers

A

impaired memory

personality and judgment affected too

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

binding domains of tau

A

3 or 4. 4 is stable

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

high levels tau protein in CSF after head trauma linked to

A

poor recovery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

inflammatory reactin oto amyloid plaques and tau tangles causes what in brain

A

gliosis leading to grey matter loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

tau protein is stained with what

A

silver stain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what condition is almost always present with alzheimers

A

cerebral amyloid angiopathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

cerebral amyloid angiopathy is due to

A

deposition of beta amyloid Abeta in small vessels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

ischemic lesions of CAA cause

A

dementia

23
Q

imaging for alzheimers

A

CSF
MRI
nuclear scans

24
Q

what is decreased or increased in alzheimers

A

decreased beta amyloid

increased tau

25
Q

part of brain most affected in alzheimers

A

CA1 hippocampus

26
Q

frontotemporal lobar degenerations inclue what?

A

pick disease
progressive supranuclear palsy
corticobasalar degeneration

27
Q

differences of frontolobar degenerations than AD

A

personality behavior and language changes appear before memory problems

28
Q

what cellular inclusions are associated with frontotemporal lobar degenerations

A

FTLD-tau group: picks, PSP, CD

FTLD-TDP43

29
Q

which cellular inclusion is associated with ALS patients that present with FTD Sx

A

FTLD TDP43

30
Q

what aggregations are present in the FTLD tau goup

A

tau aggregations

no beta amyloid

31
Q

tau aggregates in tangles

A

FTLD tau

32
Q

tau aggregates in smoothed contoured inclusions

A

pick disease

33
Q

areas with most prominent atrophy in frontotemporal lobar degeneration

A

frontal and temporal lobes

34
Q

Picks disease

A

45-65 years with confusion and FTLD
Sx have progressive course 2-5 yrs
advanced same as AD

35
Q

Pick bodies

A

tau positive

spherical cytoplasmic neuronal inclusions

36
Q

Progressive supranuclear palsy signs

A

taupathy with progressive truncal rigidity, disequilibrium with frequent falls and difficulty with voluntary eye movements

37
Q

Sx progressive supranuclear palsy

A

nuchal dystonia
pseudobulbar palsy and a mild progressive dementia
progressive truncal rigidity
disequilibrium with frequent falls and difficulty with voluntary eye movements

38
Q

onset progressive supranuclear palsy

A

5-7 decades
males>females
fatal within 5-7 years

39
Q

Parkinsons presents with

A

hypokinetic movement disorder

loss of dopaminergic neurons in substantia nigra

40
Q

dementia with lewy bodies

A

parkinson disease

41
Q

severity of motor syndrome in parkinson is proportional to

A

dopamine deficiency

42
Q

pars compacta involves what dopamine group

A

A9

43
Q

guam parkinson dementia

A

toxic amino acid in seed of cycad plant used to make flour and staple in local diet

44
Q

aluminum role in parkinson

A

can disrupt the neuronal cytoskeleton and cause neurofibrillary pathology

45
Q

parkinson syndrome can develop in course of other conditions like what

A

striatonigral degeneration, postencephalitic parkinsonism, manganese poisoning, CO poisoning, hypoxic ischemic encephalopathym traumatic brain injury and stroke

46
Q

all inputs to basal ganglia arrive where

A

striatum (caudate putamen and nucleus accumbens)

47
Q

outputs basal ganglia

A

internal segment of globus pallidus and related to substantia nigra pars compacta and reticulata

48
Q

basal ganglia controls what

A

general motor control
eye movements
cognitive functions
emotional functions

49
Q

how do you prepare a section to visualize basal ganglia

A

locate superior colliculus after cut off cerebellum

cut mid brain across superior colliculus to see substantia nigra

50
Q

central triad of parkinsonism

A

tremor
rigidity
bradykinesia(in absence of toxic or other known underlying etiology)

51
Q

clincal syndrome of parkinsonism includes

A

diminished facial expression “masked facies”
stooped posture
slowing voluntary movement
festinating gait (short progressive steps)
rigidity
pill rolling tremor

52
Q

Dx parkinsons confirmed by

A

Symptomatic response to L dopa replacement therapy

53
Q

deep brain stimulation in parkinsons

A

physiological and chemical changes that ameliorate motor Sx

54
Q

Tx unilateral tremor and rigidity in parkinsons

A

stereotactic ablation of contralateral globus pallidus, ventrolateral thalamus or subthalamic nucleus