Section 3 Lecture 7

Question 1

Which neurological disorder has an uneven distribution worldwide?

Answer 1

MS, environmental factor?

Question 2

Neurological disorders that are adult onset:

Answer 2

MS, AD, CTE (chronic taumatic encephalopathy)

Question 3

Does MS affect men or women more?

Answer 3

women, onset in 30’s

Question 4

Cause of MS:

Answer 4

multifactorial, AI process causing inflammation and destruction of myelin

Question 5

What happens to the axons after the myelin is lost?

Answer 5

it is replaced w scar-tissue-sclerosis

Question 6

scar tissue is aka:

Answer 6

scleosis

Question 7

Areas of inflammation/demy in MS:

Answer 7

plaques, seen on MRIs

Question 8

Fxns affected by MS:

Answer 8

Can be sensory, motor, cognitive, affective, depending on CNS site affected

Question 9

Biomarker for MS:

Answer 9

none

Question 10

There is an increased frequency of ___ with MS

Answer 10

seizures (2-3% w MS have seizures)

Question 11

Why is diagnosing MS sometimes difficult?

Answer 11

variability of symptoms

Question 12

Subtypes of MS:

Answer 12

Relapsing-Remitting 5%, Secondary-Progressive (after about 10 yrs), Primary-Progressive 10%, Progressive-Relapsing 5%

Question 13

Symptoms of MS worsen with:

Answer 13

inc body temps, n. impulses slow or fail

Question 14

Do MS exacerbations increase or decrease during pregnancy?

Answer 14

decrease

Question 15

Do MS exacerbations increase or decrease after pregnancy?

Answer 15

increase (inc levels of immunosuppressants in body)

Question 16

What drugs can a woman take for MS while pregnant or breastfeeding?

Answer 16

None

Question 17

Tx for MS:

Answer 17

B-interferon (Avonex), slows progression

Question 18

40-50% of people w AD are over the age of:

Answer 18

80

Question 19

Causes of AD:

Answer 19

familial: early onset, genetic OR late onset: unknown cause (env., genetics?)

Question 20

Symptoms of AD:

Answer 20

dementia, loss of cog fxn and memory

Question 21

progressive decline in memory, mental fxn, acquired intellectual skills:

Answer 21

dementia

Question 22

This is a cognitive test that can be done for AD:

Answer 22

“mini mental status exam”

Question 23

How can a PET help determine whether a person has AD or not?

Answer 23

brain activity and presence of abnormal protein (amyloid)

Question 24

Which lobes of the brain seem to accumulate amyloid at the slowest rate according to the image in the slides?

Answer 24

parietal

Question 25

3 causes for dementia besides AD:

Answer 25

vascular, Lewy body, or mixed dementia

Question 26

vascular dementia is aka:

Answer 26

vascular cognitive impairment

Question 27

What causes vascular dementia?

Answer 27

impaired blood supply (stroke or smaller bleeds or blockages), 20-30%

Question 28

What is mixed dementia:

Answer 28

combo of symptoms of vascular dementia, AD, and dementia w Lewy bodies

Question 29

Where do CNS changes occur with AD?

Answer 29

brain, cerebral cortex and subcortical structures of the limbic system

Question 30

What structures are affected first in AD?

Answer 30

Those mediating memory

Question 31

What do AD plaques contain?

Answer 31

amyloid protein and degenerated cells

Question 32

Precursors of amyloid are encoded by genes on which chromosome?

Answer 32

21

Question 33

T or F? AD leads to the eventual death of neurons.

Answer 33

T

Question 34

What are tangles?

Answer 34

hyperphosphorylated tau protein in pyramidal cells

Question 35

What nucleus supplies AcH to the cortex?

Answer 35

subcortical cholinergic nucleus

Question 36

Tx for AD:

Answer 36

block enzyme that degrades AcH (“Aricept”) or “Namenda” which blocks glutamate receps (too much glutamatergic activity can cause cell damage)

Question 37

What is death typically related to in pts w AD?

Answer 37

medical causes secondary to immobility, i.e. infections or pneumonia

Question 38

Avg life expectancy of a person w AD after diagnosis:

Answer 38

8 yrs

Question 39

Cause of CTE:

Answer 39

head injury, concussion or exposure to blast wave energy

Question 40

Symptoms of CTE:

Answer 40

Cognitive and affective symptoms (depression and suicide), problems with memory, impaired judgement, impulse control, and aggression

Question 41

Short-term effects of CTE:

Answer 41

damage to or degeneration of major axon tracts

Question 42

Long-term effects of CTE:

Answer 42

accumulation of “hyperphosphorylated tau protein” in neurons of the cerebral cortex and hippocampus, then cell death

Question 43

Tx for CTE:

Answer 43

same as AD and MS, supportive care and therapy

Question 44

3 common issues w pts w CNS damage:

Answer 44

mobility impairment, loss of fine motor control, lack of $

Question 45

What type of coordination is required to brush your teeth?

Answer 45

bimanual coordination

Question 46

Pts likely to have fine motor skill impairment:

Answer 46

MS, ALS, PD, AD, CP, DS