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Opt 637 CNS Exam 1
Dr Smith Lecture 1
39
Medical
Graduate
08/29/2011

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Cards

Term
What neurons are affeccted in alz. Dz?
Definition
loss in the hippocampus, amygdala, cortex
Term
What roles does the hippocampus play?
Definition
learning and new memory
Term
What role does the amygdala play?
Definition
connects hypothalamus --> cortex
Term
What ocular SE often presents in Alz. w/ Glaucoma pts?
Definition
greater vision loss when comorbid with glaucoma, progresses faster
Term
What is dementia?
Definition
progressive impairment of cognitive fxn
Term
What is the frequency of dementia?
Definition
14% in pts >70
Term
Does dementia affect the level of consciousness?
Definition
No.
Term
What are impaired in dementia?
Definition
cerebral cortex, and subcortical connections
Term
Are there reversible dementias?
Definition
Yes, 10% are reversible
Term
What can cause reversible dementias?
Definition
1) Intracranial mass lesions

2) Vt B12 deficiency

3) Hypothyroidism

4) neurosyphilis
Term
What is static dementia?
Definition
acute brain injury
Term
What are common causes of static dementia?
Definition
1) severe head injury

2) Ischemia from cardiac arrest

3) infections

4) Surgery for neoplasms or hemorrhage
Term
What is alz. Type progressive dementia?
Definition
slowly progressive dementia of unknown cause
Term
What % of dementia is alz. Type progressive?
Definition
70.00000%
Term
At what age does alz type dementia begin to appear?
Definition
rarely under 50
Term
What are risk factors for alz. Dz?
Definition
smoking (second hand smoke too)
HTN
obesity in midlife
high cholesterol
diabetes mellitus
dental health
lack of mental stimulation
depression
Term
What lipoprotein is often abnormal in alz. dz (though also found in normals)?
Definition
APOE-e4 (cholesterol transport); can cause an aggressive, fast track alz. Dz at a young age
Term
What lipoprotein is protective against alz dz?
Definition
APOE-e2
Term
What is the underlying pathology of alz dz?
Definition
neurofibrillary tangles and neuritic plaques

amyloid angiopathy

neurochemical abnormalities

lack of Ab to BA oligomers

elevated levels of clusterin
Term
What is the primary pathology of alz dz?
Definition
loss of Ach synapses in high brain centers
Term
Are the underlying pathologies for alz. Dz the cause of the dz?
Definition
Not necessarily. They are simply what is seen presenting with the dz itself. The cause remains not well understood.
Term
What is a neurofibrillary tangle?
Definition
Protein Tau abnormality, protein tau is what guides the microtubules along the course. Analogous to the spikes on a railroad track. This leads to tubule tangles in the neuron.
Term
Are Tau proteins extra or intracellular?
Definition
intracellular
Term
What happens when amyloid proteins are broken down?
Definition
They aggregate and form extracellular plaques between neurons --> inflammatory response --> increased COX-2
Term
Is there a loss of ACH or just ACH receptors in alz. Dz?
Definition
BOTH are seen in decreased levels
Term
What is an ocular SE occurs in Alz. Dz?
Definition
increased amyloid deposition in the lens --. Cataracts in alz. Pts and those at risk to develop alz. Dz.
Term
What are BA oligomers?
Definition
beta amyloid oligomers
Term
Is it suspected that alz. Could be a lack of immunity?
Definition
Possibility, but unproven currently
Term
What is clusterin?
Definition
An enzyme that is elevated in Alz. Pts. Could be a dx test.
Term
What does clusterin cause?
Definition
hippocampus and amygdala atrophy
Term
What are milder clinical findings in alz dz?
Definition
impaired judgment

loss of interest in hobbies

mood disturbance (depression most common)

irritability

Loss of insight

forgets names of common items

trouble with numbers and their meaning

primitive reflexes commonly found
Term
What are moderate clinical findings in alz dz?
Definition

can't recognize friends or family

 

disorientation to time and place

 

confusion

 

anxiety

 

insomnia

 

social graces lost

Term
What are severe clinical findings in alz dz?
Definition
can't remember or process new information

don't understand words

speech disorders

apraxia

bedridden
Term
What is apraxia?
Definition
inability to coordinate movement (severe clinical finding for alz dz)
Term
What chromosome # is associated with aggressive, early onset alzheimers?
Definition
Chromosome 14
Term
Do APOE proteins increase or decrease with age?
Definition
increase
Term
Insomnia is generally seen in what pt's with Alz. dz?
Definition
Female pt's.
Term
Of time, place, and person, which is generally lost first in Alz dz?
Definition
Time
Term
What are general SE of anti-cholinergic drugs?
Definition

Blind as a bat (blurred vision)



Dry as a bone (dry mouth)



Red as a beet (flushing)



Mad as a hatter (confusion)



Hot as a hare (hyperthermia)



Can’t see (vision changes)



Can’t pee (urinary retention)



Can’t (do something that rhymes with “spit”, constipation)

 

 

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