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15 Cards in this Set
- Front
- Back
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What are the three key features of dementia?
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aquired cognitive impairment
involves multiple domains of cognitive funcion no impairment of arousal- unlike delirium in which level of consciousness is a major feature |
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What are some important things to check when assessing dementia?
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Important to review all medications (prescription and OTC), herbal supplements, vitamins, etc. Also to actively look for signs and symptoms of depression and delirium.
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Most common cause of dementia in the elderly
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Alzheimer’s Disease
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What is Stage I of Alzheimer’s Disease
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memory disturbance
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What is Stage II of Alzheimer’s Disease
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aphasia
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What is Stage II of Alzheimer’s Disease
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all intellectual functions effected
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How is Alzheimer’s Disease typically inherited?
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AD
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Where is amyloid precursor protein found?
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Chromosome 21
Several different mutations identified within or close to domain coding Aβ peptide APP mutations account for < 0.1% of cases of AD Complete penetrance Onset of AD between fourth and seventh decade |
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People with trisomy 21 develop what in middle age?
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Dementia due to amyloid precursor protein
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How is the diagnosis of Alzheimer's Disease made?
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Dementia by clinical examination
Age > 40 years Deficits in two or more cognitive domains and progressive worsening of memory and other cognitive functions Absence of disturbed consciousness Exclusion of other brain diseases |
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The gross pathology of Alzheimer's Disease shows:
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hydrocephalus ex vacuo
neurofibrillary tangles paired helical filaments (PHF) hyper-phosphorylated forms of tau ubiquitin aphlabeta (a fragment of amyloid precursor protei (APP) Neuritic Plaques Use this to make the pathologic diagnosis – dense core with amyloid center Hirano bodies- pyramidal neurons of hippocampus immunoreactivity for actin. Granulovacuolar Degeneration- pyramidal neurons of hippocampus - tubulin-like immunoreactivity |
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What do you use to make the pathogenic diagnosis of Alzheimer's Disease?
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Neuritic Plaques– dense core with amyloid center
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Where are the Neuritic Plaques distributed in AD:
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Distribution of neuritic plaques: note heavy involvement of association cortex, posterior cingulate gyrus, and amygdala with relative sparing of primary motor, sensory, and visual cortices.
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What does Amyloid Angiopathy predispose the pt to?
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hemorrhage
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What is CERAD?
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Consortium to
Establish a Registry for Alzheimer’s Disease Stain with silver stain to look for plaques Come up with plaque score Combine plaque score with answer to these questions: Is there a history of dementia? Is there evidence of another neuropathologic process likely to cause dementia? |
