S9+10+11 Dementia Flashcards
Which causes of dementia are treatable (reversible) conditions? (8)
Depression. Iatrogenic. Hypothyroidism. B12 deficiency. Neurosyphilis. Normal pressure hydrocephalus. Subdural hepatoma. Encephalitis.
Name four neurodegenerative dementias.
Alzheimer’s dementia.
Lewy body dementia.
Frontotemporal dementias.
Huntingdon disease.
Differentiate between the symptoms and causes of anterior vs posterior dementias.
Anterior: behavioural changes. Normal pressure hydrocephalus, huntingdons, metabolic.
Posterior: cognition changes with normal behaviour. Alzheimers.
Differentiate between the symptoms and causes of subcortical and cortical dementias.
Sub: apathetic, slow. Parkinson’s, AIDS.
Cortical: dysphasia, agnosia, apraxia. Alzheimer’s.
What is the molecular classification of neurodegenerative dementias?
Tauopathies - frontobasal, alzheimers.
Ubiquinopathies - MND, semantic dementia.
Synucleinopathies - parkinson’s, MSA.
What is normal pressure hydrocephalus? (triad).
What are the two types?
Triad of dementia, gait disturbance and urinary incontinence.
With preceding cause (trauma, SAH, meningitis). Idiopathic.
What symptoms does hypoglycaemia lead to that mimics dementia?
Complex partial seizures. Myoclonic jerks. Slowed EEG.
But decline very rapid.
What is CJD?
A transmissible spongiform encephalopathy (named after sponge appearance of affected brain tissue).
What do EEG’s and MRI’s show in CJD?
EEG: triphasic waves.
MRI: non specific changes in basal ganglia. Variant CJD shows pulvinar sign in posterior thalamic region.
What is corticobasal degeneration?
What is it caused by?
Severe apraxia- alien limb phenomenon.
Tauopathy.
What are the genetic causes of Alzhiemers?
Increased APP - trisomy 21
Altered Aβ - Presnilin 1 and 2
What are amyloid proteins?
How do they form?
Insoluble fibrous aggregates.
APP cleaved by β and γ secretases, forms which Aβ accumulates extracellularly. Induces tau tangle formation and inflammation, causing more Aβ release.
What are tau proteins?
Which form of dementia are they seen in?
Usually stabilise microtubules in neurones. Defective means microtubules become unstable.
Alzheimer’s.
What is the role of α-Synuclein in dementia?
Forms Lewy-Bodies.
What is the function of ubiquitin?
Which form of dementia?
Small regulatory protein that directs other proteins to compartments and labels them for destruction.
Pick’s disease.
What macroscopic neuropathology is found in a brain with dementia? (4)
Decreased brain weight (900-1100g).
Atrophy in cerebral gyri, white matter, brain stem and cerebellum.
Ventricular dilatation.
Pale substantial nigra and locus cerules.
What microscopic neuropathology is found in a brain with dementia? (5)
Neuron loss from hippocampus, cerebral cortex, substantial nigra and locus ceruleus. Microvacualoation in cerebral cortex. Attenuation of white matter. Wide perivascular spaces. Accumulation of abnormal proteins.
What pathological changes are found in dementia with Lewy body? (3)
Pale substantia nigra and locus cerules (less neuromelanin).
Atrophy and neural loss.
Accumulation of of α – Synuclein +ve bodies in substantial nigra and amygdala.
Give three examples of vascular dementias.
Multi-Infarct dementia.
Binswanger’s disease.
Arteriolosclerosis.
