Deck 5b Flashcards Preview

Neurology - pathology > Deck 5b > Flashcards

Flashcards in Deck 5b Deck (17)
Loading flashcards...
1

20. Q. What occurs in fronto-temporal dementias? (FTD)

A. Damage to frontal lobe – voluntary and planned motor behaviours, motor

speech area (Broca’s), personality, planning

B. Personality and behavioural change followed by breakdown in attention and

executive function

C. Language variants: semantic dementia (SD), primary non fluent aphasia (PNFA)

D. Motor disorders plus dementia: cortico basal syndrome (CBS), progressive

supranuclear palsy (PSP), Parkinson’s disease dementia (PDD) and dementia with

lewy bodies (DLB)

2

21. Q. What is the function of the temporal lobe?

A. Hearing (superior temporal lobe

B. Language comprehension (superior temporal lobe)

C. Semantic knowledge (anterior temporal lobe)

D. Memory (hippocampus)

E. Emotional/affective behaviour (limbic system)

3

22. Q. What occurs if the hippocampus and medial temporal lobe are damaged?

A. Profound failure to create new memories, can’t remember new people, names,

tasks etc

4

Q. Where does the typical variant of Alzeheimer’s begin? What symptoms are seen?

Typical amnesia variant: Early degeneration of medial temporal love before spreading – results in selective amnesia

5

24. Q. What is seen in preclinical AD “amnesic prodrome”?

Memory impairment is first cognitive marker of AD – poor performance on

episodic memory tests (new learning and retention) – no evidence of dementia-

normal general cognitive function and activities of daily living are intact – high

risk of developing AD

6

Q. How does semantic dementia present?

Primary progressive aphasia - Loss of semantic memory in both verbal and non-

verbal domains – e.g. difficulty finding the right word

7

26. Q. What are the six parts of the six-item cognitive impairment test?

A. What year is it?

B. What month is it?

C. Give an address with 5 parts (John, Smith, 42, High, St, Bedford)

D. Count 20-1

E. Say months of year in reverse

F. Repeat address

8

Q. What is a functional memory disorder? (FMD)

A. Acquired (>6 months) dysfunction of memory that significantly affects their

professional and/or private life

B. Psychosocial burden/ significant psychological stress

C. Verbal memory and attentional capacity > -1.5SD

D. Absence of organic cause of cognitive impairment

E. Absence of major psychiatric disease, e.g. severe depression

9

Q. What is seen on autopsy of Alzheimer’s?

A. The cerebral cortex was thinner and senile plaque, previously only encountered in elderly people, were found along with neurofibrillary tangles. – dendritic/neuronal losses

10

Q. What imaging is used to stage Alzheimer’s?

A. MRI (T1)

B. Braak staging – amyloid imaging (pathology mismatch)

C. Functional MRI – brain networks

D. PET & SPECT – energy and blood supply

11

Q. What treatment is used in Alzheimer’s?

A. Acetylcholinesterase inhibitor: tacrine, rivastigmine, galantamine and donepezil
– reduce Ach breakdown rate, side effects: nausea, vomiting

B. NMDA receptor antagonist: memantine – inhibits overstimulation of NMDA receptors by glutamate (which is excessive in AD leading to cell death through excitotoxicity) –adverse effects: hallucinations, confusion, headache, fatigue,
dizziness

12

Q. What is apraxia?

A. Disorder of consciously organised patterns of movement of impaired ability to

recall acquired motor skills e.g. show me how you would light a match

13

Q. What is a motor unit?

LMN + axon + several supplied muscle fibres

14

Q. What system regulates muscle tone? What occurs in diseased states?

Muscle spindle: stretch receptor in muscle innervated by gamma motor neurons

B. Muscle stretched  afferent impulses from muscle spindles which  reflex

partial contraction of muscle

C. Disease states: e.g. spasticity and extrapyramidial rigidity

15

Q. Describe four features of LMN lesions

A. Muscle tone is normal or reduced (Flaccid)

B. Muscle wasting: predominantly distal bulbar, upper limb, lower limb, resp

muscles

C. Fasciculation: visible spontaneous contractions of motor units

D. Reflexes depressed or absent (everything goes down!)

16

Q. Describe four features of UMN lesions

A. Muscle tone is increased (spasticity)

B. Tendon reflex – (jaw jerk) are brisk

C. Plantar responses extensor + Babinski sign (big toe moves up – rather than

down)

D. Patter of limb muscle weakness – pyramidal pattern
Upper limb extensor muscle weaker than flexors

b. Lower limb flexors weaker than extensors

c. Finer more skilful movement most severely impaired

E. Emotional lability may be present

17

D. Patter of limb muscle weakness – pyramidal pattern

Upper limb extensor muscle weaker than flexors

b. Lower limb flexors weaker than extensors

c. Finer more skilful movement most severely impaired

E. Emotional lability may be present