Week 10 Dementia (Q. 10 & 11 - Neurodegenerative Disorders) Flashcards
What is Pseudodementia?
Depression
Pseudodementia (otherwise known as “depression-related cognitive dysfunction”) is a condition whose presenting symptoms appear as dementia but may result from a misdiagnosis of depression or the adverse effects of medications being taken.
Stoke is a known cause of Vascular Dementia. It affects __________ of patients following a stroke?
A. 5%
B. 5 - 10%
C. 25 - 30%
D. 35 - 50%
C. 25 - 30%
Vascular Dementia results in patients having problems with reasoning, planning, judgement, memory and other thinking skills
What is Lewy Body Dementia in your own words?
Development of abnormal proteins ‘Lewy bodies’ in nerve cells throughout the brain. Lewy Bodies disrupt normal function and spread causing deterioration.
Additionally, loss of dopaminergic cells (Substantia Nigra) mimics parkinsons disease and loss of cholinergic cells mimics Alzheimer disease
- More common in men
- Quicker progression than Alzheimer’s
- Normally ~ 7 years
True or False
A standard Rx of Lewy Body Dementia (LBD) is the administration of Neuroleptics and Antipsychotic medications.
Hint: FEVER
Neuroleptics and antipsychotics should not be used in lew body dementia, as it may have severe effects in rapidly increasing the progression of the disease and may lead to the neuroleptic malignant syndrome.
F - Fever E - Encephalopathy V - Vital dysregulation E - Enzyme elevation R - Rigidity and hyperreflexia
Physiologically, what happens to the brain as Alzheimer’s progresses?
Protein Clusters
- Neuritic Plaques and Tangles
- beat amyloid plaques found between cells
- tau and tubulin
Neocortical
- cortex become shrunken and atrophied
- sulci and gyri widen and deepen
Limbic atrophy
- the entorhinal cortex is a major relay area between Neocortex and Limbic; Hippocampus; Amygdala
- leads to memory loss
Cell Changes
Dendritic Arborization (loss of dendrite branches)
- loss of neurons: Parietal and temporal lobes
Neurotransmitter Changes
- Acetylcholine (ACh) decline from the basal forebrain which leads to memory decline
- Anti-Cholinesterase drugs are used to slow impairment in early AD
Which of these is the strongest risk factor for developing Alzheimer’s disease?
A. Heredity
B. Age
C. Exposure to toxins
D. None of the above
B. Age.
Although some studies have shown an association between certain modifiable lifestyle factors and a reduced risk for Alzheimer’s disease.
Every 5 years after 65, the likelihood doubles and the disease affects 1/4 people 85+
Sx and Sx of Alzheimer’s include which of these symptoms?
Hint: (Bitchy, Mood, Cucks)
D. All of the above.
- Behavioural Changes
- Mood Changes
- Cognitive Decline
Alzheimer’s sufferers also can’t learn new information and tend to repeat themselves
Alzheimer is principally characterised by
A. Cortical and limbic atrophy B. Ventricular Enlargement C. Loss of Neurons D. All of the above E. None of the above
D. All of the above
Early onset of Alzheimer’s Disease is associated with 3 gene mutations.
Which is NOT an affected chromosome
A. Chromosome 1
B. Chromosome 14
C. Chromosome 21
D. Chromosome 24
D. Chromosome 24
Early onset: three gene mutations;
- Chromosome 21 = abnormal amyloid precursor protein (APP)
- Chromosome 14 = abnormal presenilin 1
- Chromosome 1 = abnormal presenilin 2
- APP gene normally makes a nerve cell surface protein that helps growth and movement
- Presenilin 1 and 2 genes make proteins that are required for the correct functioning of the APP protein
What are the different types of irreversible Dementia?
All forms of Dementia are due to a physical change within the brain
Common types are
- Vascular Dementia
- Alzheimer’s Disease
- Lewy Body Dementia
There are over 75 types of dementia
Which form of Dementia is known by ‘… a disease of protein dysregulation…’ a “littering of the brain” is?
A. Vascular Dementia
B. Alzheimer’s Disease
C. Lewy Body Dementia
D. Psuedodementia
B. Alzheimer’s Disease
Generally, proteins are found in or just outside cells where they should not be.
Aka Plaques and Tangles
What are some risk factors for Alzheimer’s Disease?
Age >60 Smoking Diabetes High Cholesterol High homocysteine level Family Hx Head Injury Genetics
Apolipoprotein E is associated with early or late onset of Alzheimer’s Disease (AD)?
and
Which Chromosome is it associated with?
Late-Onest
Apolipoprotein E (ApoE) normally carrier and delivers cholesterol to nerve cells for the repair and establishment of new connections
Chromosome 19 - one gene mutation (ApoE) has been associated with an increased risk of Late-Onset AD
Which is not one of the five major anatomical and physiological changes for patients with Alzheimer’s Disease (AD)?
A. Protein Clusters - Plaques and Tangles B. Neocortical Changes C. Limbic Cortex Changes D. Cell Changes E. Neurotransmitter Changes F. Cerbrospinal Fluid Hyperplasia
F. Cerebrospinal Fluid Hyperplasia
Regarding Alzheimer’s Disease, which areas of the brain do we usually see Neuritic Plaques (aka Senile or Amyloid Plaques)?
A. Hippocampus
B. Cerebral Cortex
C. Frontal Lobe
D. A and B
D. A and B
Chiefly found in
- Hippocampus ‘primary centre for memory and learning’
- Cerebral Cortex ‘reasoning, memory, language, higher thought processes’
Increased plaques directly proportional to an increase in cognitive decline and degree of deterioration
