Week 3: Chapter 27 - Psychiatric and Related Disorders

Question 1

What are the two major clinical categories of motor disorders?

Answer 1

Hypokinetic-Rigid Syndrome and Hyperkinetic-Dystonic Syndrome.

Question 2

What characterizes hypokinetic-rigid syndromes like Parkinson’s disease?

Answer 2

Loss of movement due to basal ganglia dysfunction.

Question 3

What defines hyperkinetic-dystonic syndromes such as Huntington’s and Tourette’s?

Answer 3

Excessive or involuntary movements due to basal ganglia dysfunction.

Question 4

Who first described Huntington’s disease and in what year?

Answer 4

George Huntington in 1872.

Question 5

What are the typical age of onset and average duration of Huntington’s disease?

Answer 5

Typically begins between ages 30 and 50; average survival is about 12 years.

Question 6

What are choreas in the context of Huntington’s disease?

Answer 6

Dance-like, irregular involuntary movements.

Question 7

What types of emotional and cognitive symptoms are seen in Huntington’s disease?

Answer 7

Memory issues, slowed processing, depression, mania, and psychotic episodes.

Question 8

What is the inheritance pattern of Huntington’s disease?

Answer 8

Autosomal dominant with complete penetrance.

Question 9

Which brain structures show degeneration in Huntington’s disease?

Answer 9

Cortical thinning and atrophy of the basal ganglia.

Question 10

Which neurotransmitter imbalance is associated with Huntington’s disease?

Answer 10

Dopaminergic overactivity due to GABAergic and cholinergic neuron degeneration.

Question 11

Who described Tourette’s syndrome and when?

Answer 11

Georges Gilles de la Tourette in 1885.

Question 12

What are the three stages of symptom development in Tourette’s syndrome?

Answer 12

1. Motor tics
2. Inarticulate vocalizations
3. Vocal tics like echolalia and coprolalia.

Question 13

What is coprolalia and how is it related to Tourette’s syndrome?

Answer 13

Involuntary use of obscene language seen in some Tourette’s patients.

Question 14

What percentage of Tourette’s patients exhibit motor tics in the face?

Answer 14

97% show facial tics.

Question 15

What treatments are commonly used for Tourette’s syndrome?

Answer 15

Antidopaminergic drugs (e.g., haloperidol) and clonidine.

Question 16

What cognitive deficits are commonly found in Tourette’s patients?

Answer 16

Impairments in visuospatial tasks like the Rey Complex-Figure Test.

Question 17

Who first described Parkinson’s disease?

Answer 17

James Parkinson in 1817.

Question 18

What is the ‘pill-rolling’ tremor in Parkinson’s disease?

Answer 18

A resting tremor resembling rolling a pill between fingers.

Question 19

What is cogwheel rigidity?

Answer 19

A ratcheting resistance during passive limb movement.

Question 20

What are examples of negative symptoms in Parkinson’s disease?

Answer 20

Postural disorders, akinesia, and speech disturbances.

Question 21

What is festination in Parkinson’s patients?

Answer 21

Uncontrolled quickening of gait steps.

Question 22

What are the three major types of Parkinson’s disease?

Answer 22

Idiopathic, postencephalitic, and drug-induced.

Question 23

What toxin in synthetic heroin can cause Parkinson-like symptoms?

Answer 23

MPTP.

Question 24

What is the role of the substantia nigra in Parkinson’s disease?

Answer 24

Produces dopamine and sends projections to the cortex and basal ganglia.

Question 25

What are common pharmacological treatments for Parkinson’s disease?

Answer 25

l-dopa, MAO inhibitors, anticholinergics, amantadine.

Question 26

What is deep brain stimulation (DBS)?

Answer 26

Surgical implantation of electrodes to reduce tremor and akinesia.

Question 27

What are the goals of pharmacological treatment in Parkinson’s?

Answer 27

Increase dopamine and suppress overactive brain regions.

Question 28

What are examples of supportive therapies for Parkinson’s?

Answer 28

Physical therapy, exercise, and psychological support.

Question 29

How does Parkinson’s disease affect cognition?

Answer 29

Slowed processing, reduced motivation, and emotional flattening.

Question 30

What are some neuropsychological test results seen in Parkinson’s patients?

Answer 30

Poor performance on working memory, verbal memory, and visuospatial tasks.

Question 31

What is the projected percentage of the population over 65 in North America and Europe by 2030?

Answer 31

0.2

Question 32

What percentage of people over 80 are affected by dementia?

Answer 32

25–50%

Question 33

What is the estimated number of Americans with cognitive impairment projected for the coming decades?

Answer 33

Up to 20 million

Question 34

According to DSM-5, what distinguishes Major Neurocognitive Disorder from Mild NCD?

Answer 34

Major NCD interferes with independence; Mild NCD shows modest decline with maintained independence

Question 35

How is dementia diagnosed using standardized cognitive testing?

Answer 35

Performance 2+ SD below norms for Major NCD; 1–2 SD for Mild NCD

Question 36

What are the common causes of dementia?

Answer 36

Protein accumulations, vascular disorders, and other conditions like CTE

Question 37

What percentage of dementia cases in those over 65 is due to Alzheimer’s?

Answer 37

~65%

Question 38

Who first described Alzheimer’s disease and when?

Answer 38

Alois Alzheimer in 1906

Question 39

What are neuritic plaques made of?

Answer 39

Amyloid protein and degenerative neuronal fragments

Question 40

Where are paired helical filaments typically found?

Answer 40

Cortex and hippocampus

Question 41

What protein abnormality is associated with neurofibrillary tangles?

Answer 41

Tau protein

Question 42

Which cortical regions are most affected by Alzheimer’s disease?

Answer 42

Posterior parietal, inferior temporal, and entorhinal cortex

Question 43

What areas are relatively spared in Alzheimer’s disease?

Answer 43

Primary sensory and motor cortices

Question 44

What type of neuronal change is common in Alzheimer’s?

Answer 44

Neuronal shrinkage and dendritic loss

Question 45

Which neurotransmitters are reduced in Alzheimer’s?

Answer 45

ACh, noradrenaline, dopamine, serotonin, glutamate

Question 46

What distinguishes Alzheimer’s neurotransmitter profile from normal aging?

Answer 46

Pattern of multiple reductions, not just individual level

Question 47

What chromosome is the β-amyloid precursor protein gene located on?

Answer 47

Chromosome 21

Question 48

Which genes are linked to early-onset Alzheimer’s?

Answer 48

Presenilin 1 and 2

Question 49

Which gene is linked to tau protein dysfunction?

Answer 49

MAPT gene on chromosome 16

Question 50

What environmental factor has been found in higher levels in Alzheimer’s brains?

Answer 50

Aluminum

Question 51

How might the immune system contribute to Alzheimer’s?

Answer 51

Autoimmune destruction due to immune decline

Question 52

What are early symptoms of Alzheimer’s?

Answer 52

Recent memory loss and impaired attention

Question 53

How does Alzheimer’s typically progress?

Answer 53

From recent memory to remote memory and functional independence

Question 54

Which Wechsler subtests reveal Alzheimer’s impairments?

Answer 54

Digit symbol, block design, object assembly, verbal memory

Question 55

What does anomia in Alzheimer’s patients reflect?

Answer 55

Loss of semantic knowledge

Question 56

What kind of language deficits appear in Alzheimer’s?

Answer 56

Deficits in complex tasks despite simple conversation ability

Question 57

What pattern of hemisphere impairment does Alzheimer’s show?

Answer 57

Bilateral impairment

Question 58

What distinguishes Alzheimer’s from vascular dementia?

Answer 58

No sudden onset, bilateral and progressive symptoms

Question 59

What differs between early-onset and late-onset Alzheimer’s in the brain?

Answer 59

Early-onset: widespread atrophy; Late-onset: hippocampal atrophy

Question 60

Why is physical activity and social engagement important for aging individuals?

Answer 60

They help reduce dementia risk