Week 11 (Test 4)

Question 1

What are the characteristic gross findings in an Alzheimer’s brain?

Answer 1

neuritic plaques and neurofibrillary tangles are the characteristic findings in Alzheimer’s disease

Question 2

Which parts of the brain are primarily effected by Alzheimer’s?

Answer 2

temporal and parietal lobes

Question 3

Alzheimer’s has been linked to what allele?

Answer 3

ApoE4 allele

Question 4

What’s the most common frontotemporal dementia?

Answer 4

Pick’s disease

Question 5

Personality changes & disinhibition are often present initially, rather than appearing later as in other types of dementia.

Answer 5

frontotemporal dementias

Question 6

What’s the triad of symptoms for normal pressure hydrocephalus?

Answer 6

Wet, wacky, and wobbly

(Triad of dementia, gait apraxia, & incontinence)

Question 7

• Can include mutism, vision disturbances
• Associated with movement findings
• Gait disturbance
• Myoclonic jerks

Answer 7

CJD

Question 8

• Macrocytic anemia
• Glove stocking sensory loss and loss of vibratory sense
• Dementia can be presenting symptom

Answer 8

Vitamin B 12 deficiency

Question 9

What are the 3 Acetylcholinesterase Inhibitors used to treat dementia?

Answer 9

Donepezil, rivastigmine, galantamine

Question 10

the only FDA approved agent with glutamate blockade for dementia

Answer 10

memantine

Question 11

What’s the mechanism of action of Memantine?

Answer 11

NMDA receptor antagonist; prevents glutamate-mediated cell death via excitotoxicity.

Question 12

• memory for events, experiences or facts that are available to conscious recall.
  
  • Episodic – recollection of contextually specific events (e.g., place, time, environment, happenings, etc…).
  • Semantic – knowledge of facts (e.g., vocabulary, statistics, etc…).

Answer 12

declarative long term memory

Question 13

behavioral learning, skill acquisition, habit formation, classical conditioning; operating without conscious awareness.

Answer 13

procedural long term memory

Question 14

inability to learn or recall new information

Answer 14

anterograde amnesia

Question 15

– inability to recall previously learned information

Answer 15

retrograde amnesia

Question 16

Patients with _____ have difficulty in retaining verbal material (e.g., prose, word lists, verbal paired associate learning).

Answer 16

left medial temporal lesions

Question 17

Patients with ______ have difficulty learning nonverbal, patterned stimuli like geometric figures, faces, tonal patterns, and visual and tactile mazes.

Answer 17

right medial temporal lesions

Question 18

What’s the main characteristic to remember with delirium?

Answer 18

symptoms are WAXING AND WANING

Question 19

What class of medications is considered the most “deliriogenic”?

Answer 19

Anticholinergics

Question 20

What’s the mainstay med for treating delirium?

Answer 20

Haloperidol (Haldol)

Question 21

What drug class do you avoid when treating delirium?

Answer 21

benzos

Question 22

EtOH/sedative withdrawal presents a special case of delirium and __________ are used for management

Answer 22

benzodiazepines

Question 23

What are the Atypical Antipsychotics used to treat delirium?

Answer 23

risperidone, quetiapine, olanzapine, ziprasidone, and aripiprazole.

Question 24

How would a mutation in Presenilin-1 lead to Alzheimer’s?

Answer 24

Presenilin-1 (PS-1) is a membrane protein in the endoplasmic reticulum (ER);

• Mutations in PS-1 increase Ca2+ release
• Enhanced Ca2+ release triggers further Ca2+ influx through Ca2+ channels
• Altered Ca2+ homeostasis leads to apoptosis and excitotoxicity
• Increased Ca2+ also alters APP processing to increase Aß protein production.

Question 25

The ApoE gene associated with Alzheimers is located on which chromosome?

Answer 25

19

Question 26

Which ApoE allele is considered protective ?

Answer 26

ApoE e2

Question 27

Which ApoE allele is associated with an increased risk of Alzheimers?

Answer 27

ApoE e4

Question 28

What are Neurofibrillary tangles (in Alzheimers) composed of?

Answer 28

Composed of tau protein, a micro-tubule-associated protein (MAP)

Question 29

In Alzheimer’s, what’s wrong with the Tau proteins?

Answer 29

tau protein is excessively phosphorylated, interfering with its normal function and resulting in tangled neurofilament fibers

Question 30

What’s the observed pathology in Huntington’s?

Answer 30

• Pathology: Atrophy of caudate nucleus in basal ganglia, diffuse cortical atrophy
  
  • Loss of cholinergic and GABAergic neurons in the caudate and putamen

Question 31

Lewy body dementia has prominent ______.

Answer 31

visual hallucinations

Question 32

cause loss of executive function, disinhibition and poor social functioning with relatively well preserved memory.

Answer 32

frontotemporal dementias (like Pick’s disease

• due to problems with Tau proteins

Question 33

What are Lewy bodies composed of?

Answer 33

composed of alpha-synuclein

Question 34

Patients who can speak fluently but have trouble understanding and whose speech makes no sense

Answer 34

Wernicke’s aphasia

Question 35

Patients who can understand but have trouble getting words out or speaking fluently

Answer 35

Broca’s aphasia

Question 36

What would you find in the CSF of a patient with meningitis?

Answer 36

—CSF: normal or elevated pressure,

• — ­increased WBCs
• increased— ­ protein
• — normal or low glucose.