Week 11 (Test 4) Flashcards
(36 cards)
What are the characteristic gross findings in an Alzheimer’s brain?
neuritic plaques and neurofibrillary tangles are the characteristic findings in Alzheimer’s disease
Which parts of the brain are primarily effected by Alzheimer’s?
temporal and parietal lobes
Alzheimer’s has been linked to what allele?
ApoE4 allele
What’s the most common frontotemporal dementia?
Pick’s disease
Personality changes & disinhibition are often present initially, rather than appearing later as in other types of dementia.
frontotemporal dementias
What’s the triad of symptoms for normal pressure hydrocephalus?
Wet, wacky, and wobbly
(Triad of dementia, gait apraxia, & incontinence)
- Can include mutism, vision disturbances
- Associated with movement findings
- Gait disturbance
- Myoclonic jerks
CJD
- Macrocytic anemia
- Glove stocking sensory loss and loss of vibratory sense
- Dementia can be presenting symptom
Vitamin B 12 deficiency
What are the 3 Acetylcholinesterase Inhibitors used to treat dementia?
Donepezil, rivastigmine, galantamine
the only FDA approved agent with glutamate blockade for dementia
memantine
What’s the mechanism of action of Memantine?
NMDA receptor antagonist; prevents glutamate-mediated cell death via excitotoxicity.
- memory for events, experiences or facts that are available to conscious recall.
- Episodic – recollection of contextually specific events (e.g., place, time, environment, happenings, etc…).
- Semantic – knowledge of facts (e.g., vocabulary, statistics, etc…).
declarative long term memory
behavioral learning, skill acquisition, habit formation, classical conditioning; operating without conscious awareness.
procedural long term memory
inability to learn or recall new information
anterograde amnesia
– inability to recall previously learned information
retrograde amnesia
Patients with _____ have difficulty in retaining verbal material (e.g., prose, word lists, verbal paired associate learning).
left medial temporal lesions
Patients with ______ have difficulty learning nonverbal, patterned stimuli like geometric figures, faces, tonal patterns, and visual and tactile mazes.
right medial temporal lesions
What’s the main characteristic to remember with delirium?
symptoms are WAXING AND WANING
What class of medications is considered the most “deliriogenic”?
Anticholinergics
What’s the mainstay med for treating delirium?
Haloperidol (Haldol)
What drug class do you avoid when treating delirium?
benzos
EtOH/sedative withdrawal presents a special case of delirium and __________ are used for management
benzodiazepines
What are the Atypical Antipsychotics used to treat delirium?
risperidone, quetiapine, olanzapine, ziprasidone, and aripiprazole.
How would a mutation in Presenilin-1 lead to Alzheimer’s?
Presenilin-1 (PS-1) is a membrane protein in the endoplasmic reticulum (ER);
- Mutations in PS-1 increase Ca2+ release
- Enhanced Ca2+ release triggers further Ca2+ influx through Ca2+ channels
- Altered Ca2+ homeostasis leads to apoptosis and excitotoxicity
- Increased Ca2+ also alters APP processing to increase Aß protein production.
