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S3 Case 2 - Mental Health > Pathophysiology + Pharmacology of Dementia > Flashcards

Pathophysiology + Pharmacology of Dementia Flashcards

1
Q

What are the different types of dementia?

A

Alzheimer’s
Lewy body dementia
Vascular dementia
Front temporal dementia
Parkinson’s/ Huntington’s

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2
Q

What are the type of dementia characterised?

A

Accumulation + aggregation of misfolded proteins

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3
Q

What is the protein for Alzheimer’s?

A

Tau
Amyloid-beta

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4
Q

What is the protein for Lewy body?

A

Alpha-syn

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5
Q

When can you officially diagnose dementia?

A

After death, when receive brain tissue

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6
Q

What is seen in the brain with Alzheimer’s disease?

A

Enlargement of lateral ventricle
Severe atrophy of medial temporal lobe
Enlargement of inferior horns of ventricle
Thinning of gyri + deepening of sulci

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7
Q

What is amyloid-beta?

A

Amyloid precursor protein
= forms extracellular plaque + accumulates around blood vessels

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8
Q

What is tau?

A

Stabilise microtubules
Phosphorylated under disease conditions
= destabilise microtubule network

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9
Q

What is neuritic plaques?

A

Core = amyloid-beta
Distended halo = tau

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10
Q

What does Lewy Body dementia manifest with?

A

Parkinson’s Disease

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11
Q

What does the brain look like with Lewy Body dementia?

A

Depigmentation of substantia nigra

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12
Q

What is vascular dementia?

A

Cognitive impairment in context of altered cerebral flow
eg. after a stroke

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13
Q

What is neuronal loss mirrored by?

A

Loss of brain weight

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14
Q

What are the mainstay of dementia therapeutics?

A

Acetylcholinesterase inhibitors

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15
Q

What does acetylcholinesterase inhibitors do?

A

Stop the breakdown of Ach
= stay for longer

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16
Q

What are examples of acetylcholinesterase inhibitors?

A

Donepezil
Rivastigmine
Galantamine

17
Q

What is 1st line?

A

Donepezil

18
Q

What is the risk of Donepezil?

A

Neuroleptic malignant syndrome

19
Q

What is the risk of Rivastigmine?

A

Atrial fibrillation
Depression
Agression

20
Q

What is the risk of Galantamine?

A

Not indicated for patients with hepatic or renal dysfunction

21
Q

What are the drawbacks of AChEIs?

A

Not disease-modifying
ACh is not only the system effected

22
Q

What is alternative to AChEIs?

A

Memantine

23
Q

What is Memantine?

A

NDMA receptor antagonist
= inhibits excitotoxic glutamatergic signalling + reduce neurodegeneration

24
Q

When is Memantine more effective?

A

When combined with AChEIs

25
Q

What does Lecanemab do?

A

Targets amyloid-beta when it is just starting to stick together

26
Q
A

S3 Case 2 - Mental Health (15 decks)

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