Dementia

Question 1

Cause of dementia is sudden deterioration

Answer 1

Vascular

Question 2

Cause of dementia in gradual onset

Answer 2

Degenerative

Question 3

Cause of the dementia if rapidly progressive

Answer 3

Spongiform encephalopathy

Question 4

Classification of dementia

Answer 4

Cortical: causes selectives changes in memory function or behaviour in early stage. Can be accompanied by extrapyramidal disfunction
Subcortical: slowness of mental process, decreased motivation and mood changes predominate over impairment of intellectual functions

Question 5

Alzheimer’s disease pathological findings

Answer 5

Senil plaques made by beta-amyloid, outside neurons.
Neurofibrillary tangles, made by hyperfosforilates tau protein, inside neuron.
Tau protein unfunctional (hyperfosforilated): citoeskeletal and neuronal death

Question 6

Alzheimer’s disease PET

Answer 6

Reduced activity in the temporal ant parietal regions, accumulation of proteins

Question 7

Alzheimer therapy

Answer 7

Acetilcolinesterase inhibitors
Memantine–> NMDA blockage
Donepezil, rivastigmine, galantamine
beta-immunotherapy is in clinical trials

Question 8

Diffuse Lewi body dementia. Clinical

Answer 8

Visual and auditory hallucination
Paranoid delusions
Fluctuations in cognitive impairment
Unexplained variations in consciousness

Question 9

Lewi bodies can be found in

Answer 9

Substancia nigra
Locus ceruleis
Dorsal nucleus of vagus
Can also be in Parkinson

Question 10

Frontotemporal dementia what is

Answer 10

Atrophy in frontal and temporal lobes + hippocampus. Can have hydrocephalus
Pick’s bodies and Pick’s cells
Familiar and autonomic dominant transmission.
Mutation in TAU protein, TDP-43, FUS

Question 11

Frontotemporal dementia. Clinical

Answer 11

Behaviour: disinhibition, distractibility
Language: aphasia, anomia, use of superior word (animal instead of cat) , fluent speech, less logical. Comprenhension will get lost, words are loosing meaning, not listening.
Loss of conceptual knowledge
Mental rigid
Obsession with a procedure, food, routine
Compulsion
Loss of empathy
Prosopagnosia

Question 12

Which dementia has Pick’s bodies and Pick’s cells

Answer 12

Frontotemporal dementia

Question 13

Lacunar infarcts have predilection for

Answer 13

basal ganglia and upper pons

Question 14

Lacunar infarcts result in

Answer 14

subcortical dementia, dysarthria, marche a petit pas, extrapyramidal features.

Question 15

What to use to identify a vascular origin in dementia

Answer 15

Hachinski score

Question 16

Dementia from trauma. Frontal lobe syndrome

Answer 16

Dementia
Poor coordination and planning
Inability to change fast from one task to another
Apathy
Disorientation
Poor concentration
Loss of abstract thinking

Question 17

Cruz-feld Jacob disease (CJD)

Answer 17

Spongiform encephalopathy.
At the beginning confusion and behavioral changes and as the desease progress ir worsens. death in one year.
cause: prion mutation
Presence of 14-3-3 protein in the liquor

Question 18

Cruz-feld Jacob disease MRI

Answer 18

Increased signal in T2

Question 19

AIDS dementia

Answer 19

Associated with HIV infection
Whitte matter axonal damage and demyelination, inflammatory infiltration
Diffuse and symmetrical involvement.
Motor abnormalities, pout and grasp reflexes, mutism

Question 20

AIDS dementia treatment

Answer 20

zidovudine

Question 21

Limbic dementia is associated with

Answer 21

Lung carcinoma

Question 22

Wernicke’s dementia due to

Answer 22

B6 deficiency

Question 23

Pellagra dementia is caused by

Answer 23

Niacine deficiency

Question 24

Pellagra dementia clinica

Answer 24

Cognitive disfunction associated with extrapyramidal rigidity and primitive reflexes

Question 25

Neurotransmitter receptors affected in Alzheimer's disease

Answer 25

Acetylcholine

Question 26

Accumulation of aggregated amyloid beta protein is linked to

Answer 26

Inflammatory response of surrounding glial cells

Question 27

Test for suspected Creutzfeld Jacobs disease

Answer 27

EEG, MRI, liquor diagnostics for protein 14-3-3

Question 28

Secretases responsible for formation of amyloid A-beta

Answer 28

Beta and gamma secretases

Question 29

EEG in frontal dementia

Answer 29

normal activity

Question 30

Acetylcholine is produced in

Answer 30

Meynert's basal nucleus

Question 31

Which dementia is subcortical

Answer 31

Huntington's disease Parkinson's dementia Vascular dementia

Question 32

Pick's dementia MRI

Answer 32

Atrophy on head

Question 33

37 years old woman, double images, ataxia, confusion, amnesia is likely to have

Answer 33

Wernicke-Korsakoff syndrome

Question 34

The improvement in cognitive function with anticholinesterase therapy will be most evident in

Answer 34

Lewy body dementia

Question 35

Pathological changes in Alzheimer's disease first appear in

Answer 35

Hippocampus

Question 36

Type of aphasia in Alzehimer

Answer 36

transcortical sensory aphasia

Question 37

Lewi body part of brain

Answer 37

Substancia nigra

Question 38

Atrophy in frontotemporal process is mainly in the left temporal lobe

Answer 38

Semantic dementia

Question 39

what dementia has step-wise course

Answer 39

Vascular

Question 40

MRI visible whit dots in basal ganglia (haemorrages) and extensive atrophy of the cerebellum

Answer 40

Mixed vascular and Alzheimer's dementia

Question 41

Elevated acetylcholine causes

Answer 41

Tremor

Question 42

Extremely elevated levels of tau protein in the fluid in

Answer 42

Creutzfeldt-Jakob disease

Question 43

Brain structure affected in dementia

Answer 43

hippocampus

Question 44

ApoE4 allele may be found in

Answer 44

Sporadic Alzheimer disease

Question 45

Examples of reversible dementia

Answer 45

Cerebral tumours (particulary in frontal a and non-dominant temporal lobes) Giant aneurysm Hydrocephalus Paraneoplasic syndromes Neurosyphilis B12 deficiency Chronic drug intoxication Myxoedema Hashimoto’s encephalopathy Disturbances of calcium metabolism

Question 46

Pick’s disease types of dementia

Answer 46

Frontotemporal dementia

Question 47

Lewy bodies are made of

Answer 47

Alpha-synuclein

Question 48

Neurofibrillary tangles are made of

Answer 48

TAU protein