Alzheimers

Question 1

amyloid plaques are ___ and consist of ______

Answer 1

extracellular, AB peptide (amloid beta)

Question 2

neurofibrillary tangles are ____ and consist of _____

Answer 2

intracellular, hyperphosphorylated tau

Question 3

a feature of neurons with tangles and close to amyloid plaques is destruction of ______

Answer 3

synapses

Question 4

snapse loss results in reduced what

Answer 4

neurotransmitters - esp. acetylcholine, dopamine, serotonin, NE

Question 5

APP gene is located on

Answer 5

chromomosome 21

Question 6

things leading to early onset AD

Answer 6

mutations in APP
mutations in PSENs

Question 7

things leading to 4th decade of life AD

Answer 7

Down syndrome

Question 8

normal cleavage of AB from APP is by

Answer 8

alpha secretase

Question 9

abnomal cleavage of AB from APP is by

Answer 9

beta and gamma secretase

Question 10

which amyloid beta form can form more amloid fibrils

Answer 10

AB42 > AB40

Question 11

mutations in APP lead to more

Answer 11

cleavage by beta and gamma so more AB42

Question 12

mutations in PSEN1 or PSEN2 do what

Answer 12

alter the gamma secretase cleavage, more AB42

Question 13

AB aggregation promotes what

Answer 13

tau hyperphosphorylation

Question 14

tau hyperphosphorylation leads to what

Answer 14

neurofibrillary tangles, cytoskeletal abnormalities, disruption axonal trafficking

Question 15

AB aggregation triggers ____ activation

Answer 15

microglia
immune cell

Question 16

activated microglia do what

Answer 16

release inflammatory cytokines that cause neuroinflammation
PGs, ILs, TNF-a
release reactive nitrogen and oxygen species that cause oxidative stress

Question 17

activated microglia cause what

Answer 17

neuroinflammation
oxidative stress

Question 18

ApoE 2 vs ApoE4

Answer 18

2 - increased risk AD
4 - decreased risk AD

Question 19

cholinesterase inhibitors

Answer 19

donepezil
rivastigmine
galantamin

Question 20

donepezil MOA

Answer 20

specific reversible inhibitor AcE

Question 21

rivastigmine MOA

Answer 21

inhiitor AcE and butyrlcholinesterase

Question 22

galantamine MOA

Answer 22

selective reversible inhibitor AcE and enhances action of acetylcholine on nicotinic receptors

Question 23

anti-glutamtergic drug

Answer 23

memantine

Question 24

memantine MOA

Answer 24

NMDA antagonism that blocks glutamatergic neurotransmission via a noncompetitive mechanism,
REDUCES EXCITOTOXICITY

Question 25

what is florbetapir

Answer 25

radiolabeled agent that binds b - amyloid and is visualized by PET scanning

Question 26

dementia with Lewey bodies

Answer 26

cognitive decline and Parkinsons sx VISUAL HALLUCINATIONS cortical lewey bodies

Question 27

frontotemporal dementia

Answer 27

Picks Disease disinhibited behavior tau accumulations (Picks bodies)

Question 28

drug classes with anticholinergic burden

Answer 28

skeletal muscle relaxants tricyclic antidepressants antihistamines / emetics bladder antispasmodics

Question 29

change in MMSE score of what in 1 year is bad

Answer 29

3-4 points

Question 30

scales used to assess cognitive function

Answer 30

MMSE, MoCA

Question 31

first line therapy dementia

Answer 31

cholinesterase inhibitors donepezil rivastigmine galantamine

Question 32

when to use NMDA receptor antagonists?

Answer 32

moderate to severe dementia

Question 33

which drug should you not take with memantine

Answer 33

carbonic anhydrase inhibitors

Question 34

dementia MABs IV

Answer 34

aducanumab lecanemab

Question 35

aducanemab and lecanemab require what

Answer 35

brain MRI, ARIA presence of amyloid beta pathology prior to initaition

Question 36

what nonpharm intervention is more efficacious than antipsychotics for agitation

Answer 36

outside activities

Question 37

agitation intervention

Answer 37

take outside distraction techniques

Question 38

antipsychotics for psychosis

Answer 38

risperidone and quetiapine

Question 39

box warning antipsychotics

Answer 39

death or stroke increased in dementia

Question 40

antipsychotics are not useful for what

Answer 40

repetitive behaviors or yelling

Question 41

antidepressants used dementia

Answer 41

SSRIs, avoid paroxetine