Neurology - Dementia

___ is progressive intellectual decline which compromises social and/or occupational functioning

dementia

___ is an acute confusional state that results from systemic issues

delirium

___ is intellectual decline without change in level of function

mild cognitive impairment

After age ___ prevalence of dementia doubles every 5 years

60

What are some reversible causes of dementia?

- depression

- infection

- medication

- tumors

- metabolic disorders

- vitamin deficiencies

What are some irreversible causes of dementia?

- vascular dementia

- frontal lobe dementia

- parkinson's disease

- lewy body

- pick's disease

- HIV

What are some risk factors for dementia?

- Fhx

- metabolic syndromes

- smoking

- head injuries

- hearing loss

- vit D deficiency

- chronic sleep deprivation

What is the most common type of dementia?

alzheimer's disease

Most cases of alzheimer's disease are ___; not genetic.

sporadic

Those with alzheimer's will eventually develop ___ which is loss of learned motor behaviors

apraxia

What usually causes death in alzheimer's patients?

pneumonia or infection

Which disease is caused by accumulation of beta amyloid peptide extracellular neuritic plaques?

Alzheimer's

The gener for alzheimer's disease is found on chromosome ___

21

___ is a transmembrane protein which is cleaved BACE and y-secretase to form beta amyloid deposits

Amyloid precursor protein

Which protein can increase beta amyloid aggregation/deposition or decrease beta amyloid clearance?

Apolipoprotein E

Accumulation of tau proteins within neurons in Alzheimers is called ___

neurofibrillary tangles

Which glial cells are damaged in the sporadic form of Alzheimer's?

Microglia and astrocytes

What are some different kinds of vascular dementia?

lacunar, multi-infarct, single-infarct, binswanger

___ dementia is caused by long term poor blood flow to the brain typically caused by multiple strokes

vascular

What is caused by occlusion of a single penetrating branch of a large cerebral artery?

Lacunar infarct

Vascular dementia typically has a ___ progression whereas alzheimer's is gradual

step-wise

___ is caused by an abnormal accumulation of alpha-synuclein in neural cells

Dementia w/ lewy bodies

Which type of dementia is histologically indistinguishable from parkinson's?

Lewy body dementia

In ___ both motor and cognition are affected initially whereas in parkinson's the motor defecits precede the cognitive issues

Lewy body dementia

Which genes are associated with both alzheimers and lewy body dementia?

- APP

- PSEN1/2

- APOE

What is the only acquired risk factor of lewy body dementia?

head trauma

S/Sx of ___ include visuospatial/executive function defecits, parkinsinonian motor defecits, visual hallucinations, fluctuating delirium, REM sleep disorders, and loss of smell.

Lewy body dementia

Frontotemporal dementia is most often caused by which group(s) of disorders?

- Tau protein (pick disease)

- TAR DNA binding protein 43

Which type of dementia is typically early onset?

Frontotemporal dementia

Patient presents with personality changes and aphasia?

Frontotemporal dementia

Focal right frontal atrophy is associated with ___

ALS

What are the two pathways that can be taken for pharmaceutical treatment of alzheimers?

Glutamate pathway or ACh pathway

What are some lifestyle changes that can be made to lessen chances of dementia?

- watching weight

- exercise

- intervene early

- eat healthy

- limit alcohol intake

In which type of dementia does the patient decline over weeks to months?

Rapidly progressive dementia

Which disease is caused by prions and causes a rapidly progressive and fatal dementia?

Creutzfeldt-Jakob disease

Which type of dementia is characterized by intracellular vacuoles and loss of neurons in gray matter?

Spongiform encephalopathy in CJD