DIFF. TYPES of DEMENTIA

Question 1

What are key histological features of Alzheimer’s?

Answer 1

1. Amyloid Plaques

2. Neurofibrillary Plaques

Question 2

What genes are responsible for genetic predisposition of an individual to Alzheimer’s ?

Answer 2

• preselin gene
• APP gene
• —mutations to this gene leads to the build up Beta-amyloid peptide

Question 3

First two symptoms to arise in Alzheimer’s ?

Answer 3

1. Forgetfulness (initially, short-term memory, then remote events)
2. Disorientation (when on holiday)

Question 4

How does Vascular Dementia occur?

Answer 4

-a/w ISCHEMIC and NON-ISCHEMIC changes in the brain

Question 5

What is seen on imaging of Vascular Dementia?

Answer 5

• smaller brain and exapnded VENTRICLES
• lesions involving the FULL thickness of the white matter
• B/L multiple infarcts of the white matter

Question 6

How is Vascular dementia DIFF. from alzheimer’s?

Answer 6

• a more SUDDEN onset
• sets in the early 70s and the late 60s
• behavioural and EMOTIONAL changes tend to occur more early (even before memory loss occurs)

Question 7

What symptoms are seen in Vascular dementia

Answer 7

• Seizures

- episodes of confusion

Question 8

Name some etiological facts of Vascular Dementia.

Answer 8

• smoking
• sickle cell anemia
• carotid disease
• DM
• Atrial Fibrillation
• family hx of CVD
• coagubilities…Polycythemia
• PMH of high cholestrol and hypertension

Question 9

What are lewy bodies? Where are they predominantly found?

Answer 9

• DENSE, intracytoplasmic INCLUSIONS made of phosphorylated neurofilament proteins (Ubiquitin and Alpha-synuclein)
• basal ganglia and will later spread to the CORTEX

Question 10

What are the 3 clinical manifestations a/w with Lewy Bodies?

Answer 10

1. Dementia
2. Parkinson’s
3. Autonomic failure a/w DEGENERATION of sympathetic neurons in the spinal cord

Question 11

What are the symptoms of Lewy Body dementia?

Answer 11

• DEMENTIA
• PARKINSONISM
• VISUAL hallucinations
• FALLS
• DEPRESSION
• Sleep disorder

Question 12

How fast is the rate of DECLINE in cognition for Lewy Body Dementia?

Answer 12

• as fast as cognitive decline in Alzheimer’s

Question 13

What is seen pathologically with Fronto-temporal Dementia?

Answer 13

• ubiquitinated inclusion bodies
• loss of CORTICAL neurons
• GLIOSIS
• spongiform change