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Flashcards in Dementia (week 10) Deck (41):
1

Dementia (definition)

progressive failure of many cerebral functions that is not caused by an impaired level of consciousness

2

characteristics of dementia

-reduced cognitive function
-impaired mental abilities
-decreased ability to orient
-decreased STM, followed by LTM
-decreased language ability
-impaired judgement
-alterations of behavior

3

what occurs with dementia

memory impairments
disorientation
hallucinations
illusions
delusions
confusion

4

what is the commonality of dementias

degeneration of neurons
atrophy of cerebral cortex and basal ganglia

5

classifications of dementia

cortical
subcortical
combination

6

types of cortical dementias

Alzheimer's
Pick's

7

types of subcortical dementias

Parkinson's
Huntington's
Hydrocephalus
Endocrinopathies
Drug Intoxication
Heavy Metal Poisoning
Depression-Dementia Syndrome

8

Combination Dementias

Multiinfarct dementia
AIDS
Creutzfeldt-Jacob

9

factors that play a role in development of dementia

genetic predisposition
environment
behavior

10

testing for dementia

lab testing (to r/o other causes)
neuropsychological exam

11

How is dementia treated

no cure, tx aims to slow the progression & maximize fxn

12

most common disease that interferes with cognitive ability in people over age 65

Alzheimer's

13

Alzheimer's accounts for __-__% of cases of late life dementia

50-60

14

what accounts for the other 40-50% of cases of late life dementia

anoxic and infarct

15

primary risk factor for Alzheimer's

age; increases with each decade of age

16

What other diseases are associated with Alzheimer's

Parkinson's
Down's Syndrome

17

What is found in post mortem Alzheimer's brains

-aggregation and precipitation of amyloid
-neurofibrillary tangles

18

what makes up the neurofibrillary tangles

microtubules in nerve cells

19

what are amyloid plaques composed of

A-beta peptides

20

Amyloid cascade hypothesis for Alzheimer's

there is an imbalance in production and removal of A-beta peptides in the brain that leads to accumulation and aggregation

21

what is Amyloid

a lipoprotein

22

where are neurofibrillary tangles primarily found in Alzheimer's

hippocampus & cerebral cortex

23

what are neurofibrillary tangles composed of

hyperphosphorlyated Tau protein that are unable to bind to microtubules allowing them to collapse

24

how is the inflammatory response triggered in Alzheimer's

accumulation of A-beta peptides is attacked by microglia, which sets up inflammatory process

25

what is released during inflammatory response that is neurotoxic

cytokines
nitric acid
free radicals

26

what drug class may serve protective function against Alzheimer's

NSAIDs

27

cholinergic hypothesis

significant loss of cholinergic neurons and nicotinic receptors in hippocampus and cortex thought to be secondary to the primary process of Alzheimer's

28

have attempts to increase ACh levels in the brain been successful?

no; ACh may not have been getting to the right part of the brain to help

29

Other neurotransmitters that may contribute to Alzheimer's

-excitatory amino acids
-increased activity of MAO-B
-loss of serotonergic neurons

30

how is LDL related to Alzheimer's Disease

-some LDLs are associated with increased deposition of A-beta peptides
-AD is positively correlated with hypertension, increased LDL, and diabetes

31

What vitamins may reduce risk of AD

E & C

32

is vitamin E fat or water soluble?

fat (can be toxic)

33

is vitamin C fat or water soluble

water (can cause kidney stones)

34

How is estrogen associated to AD

estrogen may protect from AD

35

what particular behavior changes are likely to be seen in AD

irritability
agitation
restlessness

36

what types of imaging are used to diagnose AD

CAT
MRI
to check for shrinkage of sulci in cortex

37

What serologic tests are performed to r/o other causes of AD

blood cell counts
electrolytes
hepatic function
thyroid function
B12 levels

38

what pharmaceuticals can induce symptoms of AD?

sedatives and hypnotics
anticholinergics
opiates
antipsychotics
anticonvulsants
histamine receptor blockers

39

what medications are used to treat AD

-cholinesterase inhibitors for mild-moderate (improve cholinergic transmission)
-glutamate receptor antagonist (Namenda) for moderate-severe

40

what has been shown to decrease the likelihood of AD

exercise lifestyle
quality of brain (education, brain teasers, etc)

41

what AD treatment is currently under investigation

immunotherapy to increase removal of A-beta peptides