CNS Patho IV

Question 1

Whats Alzheimer’s Disease

• Pathophysiology
• Risk factors
• Presentation and why
• Gross presentation

Answer 1

Deposition of

• amyloid - Chromosome 21 (for early onset)
• • Note this is extracellular
• phosphorylated tau - giving neurofibrillary tangles - Chromosome 19 (for late onset)
• • Note this is intracellular
• Dementia, cognitive decline, immobility
• • Dementia cos of Temporal Atrophy - Hippocampus for memory
• 70% of risk deemed to be inherited
• Temporal Atrophy, parietal and other areas too

Question 2

Whats Parkinson’s Disease

• Pathophysiology
• Gross Presentation why
• Clinical presentation [3]

Answer 2

Substantial Nigra dopaminergic neurons die

• nigrostriatal pathway
• accumulation of alpha-synuclein - misfolded and clumps - Lewy bodies accumulation
• loss of neuromelanin
• • Presents as Pallor in Substantial Nigra

Clinical

• resting tremor
• hypokinesia/ bradykinesia
• Lead pipe rigidity / Cogwheel; - Hypertonia

Question 3

Huntington’s Chorea

• what isit?
• Gross Presentation

Answer 3

AD

• Huntingtin gene
• • trinucleotide repeats - hence have Anticipation w next generation;
• • PROTEIN ACCUMULATION IN BG
• • loss of striatal neurons; loss of cortical neurons
• Cortical Atrophy ; Basal Ganglia Atrophy
• Cognitive decline; aspiration pneumonia, abnormal movements, swallowing difficulties

Question 4

3 effects of alcohol on CNS

Answer 4

Fetal Alcohol Syndrome
- growth retardation

Acute intoxication - respiratory depression - death

Chronic alcoholism

• cerebral, cerebellum atrophy
• Thiamine, B1 deficiency + Korsakoff Psychosis
• • from severe malnutrition

Question 5

Chronic alcoholism Cx

Answer 5

Wernicke Encephalopathy from B1 deficiency

• • B1 is thiamine
• psychotic syndrome; necrosis, hemorrhage

Persistent B1 deficiency leads to Korsakoff Psychosis

• AMNESIC DISORDER
• Amnesia both anterograde and retrograde
• • Confabulation, invented memories during blackout

Question 6

Basal Ganglia functions

Answer 6

• primarily for motor control, as well as other roles such as motor learning, executive functions and behaviors, and emotions.

Question 7

Parkinson and Huntington’s Chorea similarities

• Differentiate Chorea, athetosis, Dystonia and Dyskinesia

Answer 7

Basal Ganglia affected
- Both motor functions

Chorea is uncontrolled movement
Athetosis is writhing

Dystonia is repetitive movement
Dyskinesia is uncontrolled movement