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Flashcards in Alzheimers Deck (43):
1

most epileptic part of the human brain

hippocampus

2

HM characteristics, conclusion?

LT memory was impaired, but other cognitive functions were intact; function of LT memory is separate from other cognitive functions

3

bundle of white matter fibers leaving the hippocampus twd the thalamus/BG/forebrain

lesion in this structure causes?

fornix
lesion --> anterograde amnesia (cannot provide ACh to hippocampus)

4

another structure crucial to memory formation?

medial temporal lobes

5

associative memory: hearing a sound and assoc w a person and his life story

tying shoes

hippocampus

not assoc w/hippocampus - don't need to remember contextual features

6

declarative (explicit) memory

nondeclarative (implicit) memory

medial temporal dependent (event learning; recall/recognition)

independent

7

common complication of dural atrophy

subdural hematoma (easily torn)

8

Senile plaques

EC deposition of fibrillar amyloid-B (inflammation, cytokines, complement etc)

9

degeneration of neurons via?

phosphorylation of tau protein leads to aggregation and degeneration

10

amyloid angiopathy

found in vessels and leads to breakage

11

role of microglia

activated and phagocytose debris

12

amyloid hypothesis

AB generation leads to adverse effects; defect in the gamma secretase --> breaks down precursor amyloid in abnormal way generating B-Amyloid --> oxidation, aggregation, inflammation, tau hyperphosphrylation (and microtubules) --> plaques and tangles --> cell death, NT deficit --> cognitive and behavioral changes

13

definition of dementia (MND): multiple realms

impaired memory
disturbed language
visuospatial abnormalities
decreased problem-solving, abstraction and other exec fxns
reduced attention
apraxia
agnosia

end-stage includes deficits in them all

14

most common cause of dementia?

alzheimers
the older you are, the more common the cause of dementia is alzheimers

15

core issue of alzheimers

memory loss
as progresses, further into disease further back memory recall problems become

16

visuospatial problems due to

parietal damage

17

can't groom, take meds, feed oneself

severe alzheimers

18

common mut in alzheimers
rare
downs

apo-e4 (double risk)
rare: secretases
downs: have an extra copy of the amyloid precursor protein gene so deposit more amyloid since birth

19

increase in which enzyme in alzheimers?

butyrocholinesterase

20

sudden onset of problems w/attention and arousal

delirium
irreversible

21

central symptom of alzheimers

amnesia

22

5 A's of alzheimers

Aphasia, apraxia, agnosia, executive fxn (abstract reasoning, activities of daily living)

23

conscious, recollective memory

past experiences influence present performance in absence of specific memory

explicit/declarative

implicit/nondeclarative

24

declarative (not non declarative) memory impaired in what kind of amnesia?

anterograde

25

type of declarative LTM that includes where/who with/what time etc --> context/source

type of declLTM that contains factual info but not assoc w specific event

episodic memory

semantic memory

26

HM lobectomy?

bilateral medial temporal lobe (hippocampus)
language remained normal, IQ increased

27

role of hippocampus

encoding as well as retrieval

28

brain atrophy most severe where?

frontal/temporal lobes

29

accumulations of paired helical filaments in neuronal cytoplasm; birefringent under polarized light and visualized using silver stain

neurofibrillary tangles

30

genetics of alzheimers
which two chromosomes?
which two genes?
which two NT's are decreased?

dominant!
chromosome 14: presenilin-1
chromosome 1: presenilin-2
apoE-e4 --> higher risk and earlier onset
apoE-e2 is protective
ACh and somatostatin

31

single most powerful risk factor for dementia?
other risk factors?

age --> 45% over 95y have it
genetics (apoE4, family hx of alz, hx of TBI, dearth of education, late-life depression, CV risk fx

32

most common cause of dementia?
core sx of dementia?

alzheimer's
amnesia (2-3y prior to dementia dx)
STM first, then LTM
aphasia, visuospatial, exec dysfxn

33

criteria for MND due to alzheimers

A. Criteria met for major/mild NCD
B. Insidious onset/gradual progression of impairment in 1+ cognitive domains
C. Criteria met for alzheimers (probable if either of the following, otherwise "possible"):
1. causative genetic mutation
2. all 3 of the following: a) decline in memory/learning and 1+ other domain; b) steadily prog/gradual decline in cognition w/o extended plateaus; c) no evidence of mixed etiology

34

prognosis

most pts btwn 75-85y
6-12y from dx to death

35

donepezil, galantamine, rivastigmine, memantine not effective for?

frontotemporal dementia

36

meds used in dementia
which med assoc w incr mortality in elders w/dementia?

SSRI's and atypical antipsychotics
atypical antipsychotics

37

strokes here lead to problems with attention

strokes here lead to apathy, disinhibition

parietal lobe
frontal

38

sudden change in cognitive fxn indicates?

cerebrovascular incident

39

the onset of cognitive sx at least 1y after onset of motor sx, impairment due to Lewy bodies

1) fluctuating sx, 2) visual hallucinations, 3) cognitive impairment, 4) less severe parkinsonian sx than in parkinsons

levy bodies found where?

parkinson's disease dementia

DLB

cerebral cortex

40

presence of tau inclusion bodies on histo
lobar degeneration of frontal/temporal lobe
behavioral disturbance/aphasia

FTD

onset 50-65y

41

when do you know dx of FTD?
course of FTD? death when?

when tx (antidepr/mood stabz) not effective
more rapid than other dementias
death w/in 5y of dx

42

other causes of dementia

huntington's
CJD
neurosyphilis
wernicke-korsakoff syndrowm (alcohol dementia)
CTE
CNS tumors
HIV/AIDS

43

reversible causes of dementia

depression, hypothyroid, B12 def, pressure hydrocephalus, subdural hematoma