Dementia And Alzheimer's Disease

Front 1

Dementia

Back 1

global deterioration of intellectual function in the face of unimpaired consciousness

Front 2

What are the six categories of the assessment of mental state (bedside tests: MMSE and MOCA)?

Back 2

-level of consciousness
-orientation (time, place, person)
-memory (remote, recent, immediate)
-attention and concentration
-knowledge and insight
-language

Front 3

Pout reflex

Back 3

tap lips with tendon hammer--a pout response is observed

Front 4

Grasp reflex

Back 4

stroking palm of hand induces grasp

Front 5

Glabellar reflex

Back 5

patient cannot inhibit blinking in response to stimulation (tapping between eyes)

Front 6

Palmo-mental reflex

Back 6

quick scratch on palm of hand induces sudden contraction of mental is muscle in face

Front 7

Where does the anterior pathway of dementia take place, and what are four symptoms associated with it?

Back 7

-frontal pre-motor cortex
-behavioural changes/loss of inhibition, antisocial behaviour, facile, and irresponsible

Front 8

Where does the posterior pathway of dementia take place, and what are the two symptoms associated with it?

Back 8

-parietal and temporal lobes
-disturbance of memory and language without marked changes in behaviour

Front 9

The anterior pathway can lead to which two other dementias?

Back 9

frontotemporal dementia (Pick's) and huntington's disease

Front 10

The posterior pathway can lead to which disease?

Back 10

alzheimer's disease

Front 11

Causes of dementia (7)

Back 11

-degenerative
-cerebrovascular
-structural
-infections
-toxic/metabolic
-immune disorders and cancer
-depression

Front 12

What are three examples of degenerative causes of dementia?

Back 12

-lewy body dementia
-tauopathies (frontotemporal--Pick's disease, progressive supra nuclear palsy)
-wilson's disease (hepatolenticular degeneration)

Front 13

What are four examples of infectious causes of dementia?

Back 13

-creutzfeld-jacob disease
-neurosyphilis
-HIV
-sequelae of viral encephalitis

Front 14

What are four examples of toxic/metabolic of dementia?

Back 14

-vitamin deficiencies (B12, thiamine, folate)
-hypothyroidism
-uremia and dialysis related
-hepatic encephalopathy

Front 15

How many neurons, and synapses are in the human brain?

Back 15

100 billion neurons and 100 trillion synapses

Front 16

What three essential functions of neurons does alzheimer's disease disrupt?

Back 16

-communication
-metabolism
-repair

Front 17

Symptoms of alzheimer's disease (7)

Back 17

-impairment of memory and attention
-language and comprehension
-abstract thinking
-judgement
-personality changes
-depression
-visuo-spatial disorientation

Front 18

Signs of alzheimer's disease (4)

Back 18

-motor and gait disturbance
-extrapyramidal signs
-sphincters
-seizures

Front 19

What are the four susceptibility genes involved in alzheimer's disease?

Back 19

-APP mutation
-apolipoprotein E
-presenilin 1 and 2 mutations
-SORL 1

Front 20

What are five indications of alzheimer's disease presented in neuropathology?

Back 20

-cortical atrophy
-synaptic and neuronal loss
-NFTs with paired helical filaments (hyperphosphorylated forms of the microtubule-associated protein tau)
-neuritic plaques with amyloid core
-amyloid angography

Front 21

Brains of people with AD have an abundance of which two abnormal structures?

Back 21

-beta-amyloid plaques: which are dense deposits of protein and cellular material that accumulate outside/around nerve cells
-neurofibrillary tangles: which are twisted fibres that build up inside the nerve cell

Front 22

Amyloid precursor protein (APP)

Back 22

membrane protein sitting on membrane and extending outwards to assist in neuronal growth, survival and repair

Front 23

What is the most important enzyme for cutting the APP?

Back 23

beta-amyloid

Front 24

What chemical messenger is decreased in AD, and where (2)?

Back 24

acetylcholine in the cortex and hippocampus

Front 25

What are the three current drugs for alzheimer's disease and what is their mechanism?

Back 25

-aricept, exelon, reminyl
-inactivate the enzyme ACh-esterase

Front 26

What are four cholinesterase inhibitors (symptomatic) drugs for AD?

Back 26

-donepezil
-rivastigmine
-galantamine
-tacrine

Front 27

Memantine

Back 27

a non-cholinergic agent (glutamate receptor modular)

Front 28

What are three non-cholinergic agent possible treatments for AD?

Back 28

-amyloid vaccine
-secretase inhibitors
-anti-amyloid agents

Front 29

What are four non-cholinergic agent unproven treatments for AD?

Back 29

estrogens, NSAIDs, vasodialators, and propentofylline

Front 30

What are some laboratory investigations of AD? (13)

Back 30

CBC, ESR, thyroid function tests, B12, folate, serum electrolytes, glucose, BUN, creatinine, calcium, liver function tests, toxicity screen

Front 31

What are four symptoms of dementia with lewy bodies, and what are two treatments?

Back 31

-fluctuating cognition, variation in attention and alertness, recurrent visual hallucinations, and parkinsonian features
-cholinesterase inhibitors and atypical antipsychotics

Front 32

What is a unique pathological effect of DLB that resembles PD?

Back 32

loss of pigmented neurons in the substantial nigra

Front 33

Symptoms of frontotemporal dementia (Pick's disease) (5)

Back 33

-disinhibition
-apathy
-perseveration
-mental rigidity
-affective symptoms

Front 34

What pathology was most frequently observed with FTD?

Back 34

tau

Front 35

The gene on what chromosome is associated with FTD?

Back 35

17

Front 36

Vascular dementia accounts for what percentage of dementias?

Back 36

10-15%