Week 2

Question 1

What is the usual cause of death in Alz. Dis?

Answer 1

Pneumonia

Question 2

What are the typical neuronal changes in alzheimers?

Answer 2

• Paired helical filaments
• HYPERphosphorylation of Tau
• Microtubule Assoc. Protein problems (MAP)
• Ubiquitin
• Formation of Neuropil Threads

Question 3

This diagnosis guideline primarily distinguishes alz. disease based on: 1)Braak and Braak 2)CERAD

Answer 3

1) Neurofibblary Tangle Location

2) Neuritic plagues, age, clinical findings

Question 4

What is both thought to be the reason for inflammation of Alz. disease and its classification?

Answer 4

BETA-Amyloid

Question 5

What are some important familial genes in Alz?

Answer 5

• BAPP (CHROMOSOME 21 ASSOC. with Down syndrome)
• Presenilin 1 (14)
• Presenilin 2 (1)

Question 6

What are some important sporadic genes in Alz. Disease?

Answer 6

ApoE e4 (19)
IL-1A&B (2)

Question 7

TDP-43 is heavily present protein in what neurodegenerative disease?

Answer 7

Frontal Temporal Dementia

Question 8

Progressive language and personality dysfunction is a heavily prevalent sign in what neurodegenerative disease? What are some pathological distinguishers in this disease?

Answer 8

Frontal Temporal Dementia! Pick bodies are present in this (with and without positive tau bodies)

Question 9

What do Dementia with Lewy Bodies, MSA, and Parkinsons have in common?

Answer 9

They are synucleuinopathies (alpha synucleuin accumulation)

Question 10

Lewy bodies present in the cerebral cortex is indicitive of what?

Answer 10

Dementia With Lewy Bodies

Question 11

Vertical gaze, truncal rigidity, NO tau mutations, and globose NFT in globus pallidus, SN, and dentate nucleus is indicative of?

Answer 11

Progressive supranuclear palsy

Question 12

Extrapyramidal rigidity, alien hand, cognitive decline, BALLOONED neurons w/ tau positive astrocytes is indicative of what?

Answer 12

Corticobasal Degeneration

Question 13

Multiple system atrophy typically involves what parts of the cns? What cell type is typically affected?

Answer 13

Pons, medulla, substantia niagra, striatum. Glial cytoplasmic inclusions, typically OLIGODENDROGLIA

Question 14

What areas are affected in MSA-P?

Answer 14

Striatonigral degeneration (parkinosonism dominant)

Question 15

What areas are affected in MSA-C?

Answer 15

Olivopontocerebellar atrophy (cerebellar dysfunction-dominant)

Question 16

Which multiple system atrophy is treated differently than the other two? And what does it pertain to?

Answer 16

MSA-A (Shy Drager Syndrome)

-Autonomic dysfuntion dominant

Question 17

What two areas of the brain predominantly show atrophy in Huntingtons?

Answer 17

Caudate nucleus and putamen (atrophy of striate nuclei)

Question 18

Which neurodegenerative disease is characterised by trinucleotide repeats on chromosome 4?

Answer 18

Huntingtons Disease

Question 19

Which neurodegenerative disease is characterized by LARGE involuntary movements (chorea)?

Answer 19

Huntingtons Disease

Question 20

Which neurodegenerative disease is characterized by loss of anterior horn motor neurons and is typically set off in middle age? What is it called if it is present in an infant?

Answer 20

Amyotrophic Lateral Sclerosis

Werdnig - Hoffman Disease

Question 21

What’s required for a diagnosis of PD?

Answer 21

Bradykinesia with one of the following
-tremor
-rigidity
Also must have good response to L-Dopa

Question 22

What parts of the brain show hypometabolism in PET scans in pts. With Alzheimer’s?

Answer 22

Parietal and Temporal

Question 23

Hemibody weakness (face, arm, and leg) suggests a lesion where?

Answer 23

Posterior limb of the opposite internal capsule or massive hemispheric stroke

Question 24

Weakness of one side of the body and the other side of the face suggests lesion where?

Answer 24

Lesion on the side of facial weakness

Question 25

Weakness and loss of propioception of one leg and loss of pain sensation on the other suggests:

Answer 25

Hemicord Lesion (Brown Sequard)

Question 26

Weakness with sensory loss and decreased reflexes is due to what?

Answer 26

Nerve Disease

Question 27

Fluctuating weakness w/ eyelid ptosis and DIPLOPIA suggests?

Answer 27

Neuromuscular Junction Disease

Question 28

Pure motor weakness with fasiculations and extensor plantar reflexes suggests what?

Answer 28

ALS or Cervical Cord Lesion

Question 29

``` Acute/Sudden onset of: -Stroke/TIA -Brain Hemorrhage -Bell's Palsy Is classified under what type of location? ```

Answer 29

FOCAL

Question 30

Fainting, seizure, tramautic brain injury, meningitis, and delirium are suggestive of what type of localization and timing?

Answer 30

- Diffuse | - Acute/Sudden Onset

Question 31

Multiple Sclerosis, and inflammatory neuropathis are suggestive of what timing and localizaiton?

Answer 31

- Recurrent | - Focal

Question 32

Migraine headaches, epilepsy, sleep disorders are suggestive of what timing and localization?

Answer 32

- Recurrent | - Diffuse

Question 33

Distinguishing between: 1)focal and diffuse 2) Chronic Progressive vs. Chronic static Differentiate: Brain tumors, brain abcess, dementia, old stroke, old trauma, mental retardation, cerebral palsy, myopathy, PD, ALZ, Neurodevelopmental disorders.

Answer 33

``` Focal Chronic Progressive: -Brain Tumors, brain abcess Diffuse Chronic Prog.: -Dementia, diabetic np, myopathy, PD, ALZ Focal Chronic Stat: -Old Trauma, old stroke Diffuse Chronic Stat -Mental retardation, cerebral palsy, neurodevelopmental D/O's ```

Question 34

Patients who can speak a large volume of words but can neither understand or produce sensible language have what type of aphasia?

Answer 34

Wernicke's Aphasia (SENSORY) | -Left Parietal Lobe Angular Gyrus

Question 35

Pts. who can understand speech but cannot verbally produce it have what type of aphasia?

Answer 35

Broca's Aphasia (MOTOR) | Lesion is in the LOWER LEFT FRONTAL LOBE

Question 36

Patients who can neither understand nor speak words is suggestive of what?

Answer 36

GLOBAL APHASIA (LARGE LESION OR MCA STROKE!)