Module 11 Quiz (PART 1)
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Questions and Answers

Which of the following is a symptom of Alzheimer's Disease?

  • Improved memory
  • Increased appetite
  • Difficulty falling asleep
  • Forget whole experiences (correct)

    • What is the number one risk factor for Alzheimer's Disease?

  • High cholesterol
  • Genetic defect
  • Smoking
  • Age (correct)

    • Which protein is responsible for plaque formation in Alzheimer's Disease?

  • Tau
  • Amyloid precursor protein
  • Acetylcholine
  • Beta amyloid (correct)

    • What is the impact of plaque formation on the brain in Alzheimer's Disease?

    <p>Formation of neurotoxic plaque</p> Signup and view all the answers

    What is the impact of Alzheimer's Disease on acetylcholine and nerve conduction in the brain?

    <p>No neurotransmitter production</p> Signup and view all the answers

    Where do tangles develop in Alzheimer's Disease?

    <p>Cytoplasm of neurons</p> Signup and view all the answers

    What is the impact of tangles on the cells of the brain in Alzheimer's Disease?

    <p>Neuron cell death</p> Signup and view all the answers

    Where does Alzheimer's Disease typically start and how does it progress in the brain?

    <p>Hippocampus - memory impairment</p> Signup and view all the answers

    What is the definitive diagnostic test for Alzheimer's Disease?

    <p>Autopsy</p> Signup and view all the answers

    What is the mechanism of action of cholinesterase inhibitors in the treatment of Alzheimer's Disease?

    <p>Increase acetylcholine neurotransmitter</p> Signup and view all the answers

    What is the genetic basis for Huntington's Disease?

    <p>Chromosome 4</p> Signup and view all the answers

    Which of the following is an early symptom of vascular cognitive impairment (VCI)?

    <p>Memory loss</p> Signup and view all the answers

    Which region of the brain does Huntington's Disease primarily affect?

    <p>Motor control regions</p> Signup and view all the answers

    What is the role of MRI in the diagnosis of VCI?

    <p>To detect lacunar infarctions</p> Signup and view all the answers

    What is the main consequence of foam cell rupture in atherosclerosis?

    <p>Narrowing of the artery</p> Signup and view all the answers

    What is the characteristic age of onset for Huntington's Disease?

    <p>Between 30 and 50 years</p> Signup and view all the answers

    What is the main effect of Huntington's Disease on physical abilities?

    <p>Stumbling and clumsiness</p> Signup and view all the answers

    What is the underlying cause of neurodegeneration in Huntington's Disease?

    <p>Breakdown of nerve cells</p> Signup and view all the answers

    What is the consequence of ischemic brain tissue progressing to necrosis?

    <p>Dementia</p> Signup and view all the answers

    What is the primary cause of altered perfusion in atherosclerosis?

    <p>Plaque formation</p> Signup and view all the answers

    Which of the following best defines dementia?

    <p>Impairment of memory, abstract thinking, judgment, and personality</p> Signup and view all the answers

    Which of the following is an etiology for dementia/chronic confusion?

    <p>Alzheimer's Disease</p> Signup and view all the answers

    What is the main difference between dementia and confusion?

    <p>Dementia is irreversible and confusion is reversible</p> Signup and view all the answers

    What is the etiology of Lewy Body Dementia?

    <p>Build-up of Lewy bodies in brain tissues</p> Signup and view all the answers

    Which of the following is NOT an etiology for dementia/chronic confusion?

    <p>Anemia</p> Signup and view all the answers

    What percentage of cases of dementia/chronic confusion are attributed to Alzheimer's Disease?

    <p>60%</p> Signup and view all the answers

    Which of the following is a characteristic of dementia?

    <p>Changes in personality and significant interference in work or social activities</p> Signup and view all the answers

    What is the work-up for acute confusion primarily aimed at identifying?

    <p>Underlying medical conditions or factors contributing to confusion</p> Signup and view all the answers

    Which of the following is NOT a factor that can contribute to acute confusion?

    <p>Intracranial pathos</p> Signup and view all the answers

    What is the main difference between dementia and confusion in terms of reversibility?

    <p>Dementia is irreversible and confusion is reversible</p> Signup and view all the answers

    A person experiences an altered level of consciousness, disoriented to time, person, or place; disturbed mental status. Differentiate ______ from confusion.

    <p>dementia</p> Signup and view all the answers

    ______ is the impairment of memory, abstract thinking, judgment, and personality, and other higher cognitive functions, resulting in changes in personality and significant interference in work or social activities.

    <p>Dementia</p> Signup and view all the answers

    Dementia is more permanent and irreversible, all have ______. Confusion is more reversible and helps correct the situation that has resulted in confusion since not all cases of confusion have dementia.

    <p>confusion</p> Signup and view all the answers

    Hypothyroidism: Side effect drugs Heart Failure: Myocardial infarction: Depression: Dehydration & electrolyte imbalance Alcohol abuse Infections in the elderly: Anemia: Renal failure: ______: Liver disease: Malnutrition Intracranial pathos Describe etiologies for dementia/chronic confusion.

    <p>Liver disease</p> Signup and view all the answers

    Lewy Body Dementia (LBD) is a progressive brain disorder. The neuron has trouble processing alpha-synuclein protein fragments. Lewy bodies build up in the Brain tissues. There is a ↓ in the neurotransmitter Acetylcholine. Bottom Line: problems in areas of the brain that regulate behavior, cognition, and ______.

    <p>movement</p> Signup and view all the answers

    ______ Alzheimer’s Disease

    <p>60%</p> Signup and view all the answers

    AD means neuron cell ______.

    <p>death</p> Signup and view all the answers

    Less acetylcholine is available at the ______.

    <p>synapse</p> Signup and view all the answers

    Give a drug to block ______.

    <p>cholinesterase</p> Signup and view all the answers

    More acetylcholine at neuron ______.

    <p>synapse</p> Signup and view all the answers

    Strength of impulse transmission is ______.

    <p>improved</p> Signup and view all the answers

    Increase ability to send messages to various parts of the ______.

    <p>brain</p> Signup and view all the answers

    May slow the cognitive decline of the ______.

    <p>disease</p> Signup and view all the answers

    Decrease ______- Increased release-neurotoxic.

    <p>glutamate</p> Signup and view all the answers

    Vascular cognitive impairment (VCI) - is a decline in thinking skills caused by a condition that ______ or reduce arterial blood flow to the brain.

    <p>blocks</p> Signup and view all the answers

    Vascular cognitive impairment (VCI) is characterized by difficulty concentrating, memory lapses, depression, stumbling and clumsiness, and mood swings. These ______ are a result of altered perfusion in the brain.

    <p>signs and symptoms</p> Signup and view all the answers

    ______ is an inherited disorder that causes nerve cells in parts of the brain to gradually break down and die. It primarily attacks motor control regions of the brain.

    <p>Huntington's Disease</p> Signup and view all the answers

    The genetic basis for Huntington's Disease is located on ______ and follows an autosomal dominant inheritance pattern.

    <p>chromosome 4</p> Signup and view all the answers

    In Alzheimer's Disease, ______ impacts the brain by disrupting normal neuronal function and leading to cognitive decline.

    <p>plaque formation</p> Signup and view all the answers

    ______ is an early symptom of vascular cognitive impairment (VCI).

    <p>Memory loss</p> Signup and view all the answers

    The main consequence of foam cell rupture in atherosclerosis is the ______ of the vessel (artery), leading to decreased blood flow and ischemic tissues.

    <p>narrowing</p> Signup and view all the answers

    MRI plays a role in the diagnosis of VCI by providing ______ of the brain, allowing for the detection of multiple small cerebral infarctions and lacunar infarctions.

    <p>detailed images</p> Signup and view all the answers

    The characteristic age of onset for Huntington's Disease is often between the ages of ______.

    <p>30 and 50</p> Signup and view all the answers

    ______ is a progressive decline in cognitive function, characterized by memory loss, confusion, and impairment in daily activities.

    <p>Dementia</p> Signup and view all the answers

    ______ plays a significant role in the development of Alzheimer's Disease, with chromosome 19 and 21 being implicated in early-onset and late-onset cases, respectively.

    <p>Genetics</p> Signup and view all the answers

    The etiology of Lewy Body Dementia is the ______ of abnormal protein deposits called Lewy bodies in the brain.

    <p>accumulation</p> Signup and view all the answers

    Where does Alzheimer's Disease typically start and how does it progress in the brain?

    <p>Starts: Hippocampus - (Memory) Impairment is an early symptoms. Up over and around the brain. Goes to the frontal lobe - problem solving, judgment. Limbic systemic - emotions - angry.</p> Signup and view all the answers

    ______ is a characteristic of vascular cognitive impairment (VCI).

    <p>Memory loss</p> Signup and view all the answers

    ______ is the genetic basis for Huntington's Disease.

    <p>Chromosome 4</p> Signup and view all the answers

    ______ is an early symptom of Huntington's Disease.

    <p>Memory lapses</p> Signup and view all the answers

    ______ affects the basal ganglia and mental capabilities in Huntington's Disease.

    <p>Deterioration of physical ability</p> Signup and view all the answers

    ______ is an inherited disorder that causes nerve cells in parts of the brain to gradually break down and die.

    <p>Huntington's Disease</p> Signup and view all the answers

    ______ is the main consequence of foam cell rupture in atherosclerosis.

    <p>Narrowing of the vessel (artery)</p> Signup and view all the answers

    ______ is a decline in thinking skills caused by a condition that reduces arterial blood flow to the brain.

    <p>Vascular cognitive impairment (VCI)</p> Signup and view all the answers

    ______ is the impairment of memory, abstract thinking, judgment, and personality, and other higher cognitive functions, resulting in changes in personality and significant interference in work or social activities.

    <p>Dementia</p> Signup and view all the answers

    A person experiences an altered level of consciousness, disoriented to time, person, or place; disturbed mental status. Differentiate ______ from confusion.

    <p>dementia</p> Signup and view all the answers

    ______ Alzheimer’s Disease

    <p>60%</p> Signup and view all the answers

    ______ Vascular (Atherosclerosis)

    <p>5%</p> Signup and view all the answers

    ______ plays a significant role in the development of Alzheimer's Disease, with chromosome 19 and 21 being implicated in early-onset and late-onset cases, respectively.

    <p>genetics</p> Signup and view all the answers

    Lewy Body Dementia (LBD) is a progressive brain disorder. The neuron has trouble processing alpha-synuclein protein fragments. Lewy bodies build up in the Brain tissues. There is a ↓ in the neurotransmitter Acetylcholine. Bottom Line: problems in areas of the brain that regulate behavior, cognition, and ______.

    <p>movement</p> Signup and view all the answers

    ______ is an inherited disorder that causes nerve cells in parts of the brain to gradually break down and die. It primarily attacks motor control regions of the brain.

    <p>Huntington's Disease</p> Signup and view all the answers

    ______ is the etiology of Lewy Body Dementia.

    <p>formation</p> Signup and view all the answers

    What are the etiologies for dementia/chronic confusion?

    <p>60% Alzheimer's Disease, 15% Lewy Body Dementia, 10% Mixed, 10% Other, 5% Vascular (Atherosclerosis)</p> Signup and view all the answers

    Describe the etiology for Lewy Body Dementia.

    <p>Lewy Body Dementia (LBD) is a progressive brain disorder. The neuron has trouble processing alpha-synuclein protein fragments. Lewy bodies build up in the brain tissues. There is a decrease in the neurotransmitter Acetylcholine. Bottom Line: problems in areas of the brain that regulate behavior, cognition, and movement.</p> Signup and view all the answers

    Differentiate dementia from confusion.

    <p>Dementia is more permanent and irreversible, all have confusion. Confusion is more reversible and helps correct the situation that has resulted in confusion since not all cases of confusion have dementia.</p> Signup and view all the answers

    What is the workup for acute confusion?

    <p>Hypothyroidism, Side effect drugs, Heart Failure, Myocardial infarction, Depression, Dehydration &amp; electrolyte imbalance, Alcohol abuse, Infections in the elderly, Anemia, Renal failure, Liver disease, Malnutrition, Intracranial pathos</p> Signup and view all the answers

    Define confusion.

    <p>A person experiences an altered level of consciousness, disoriented to time, person, or place; disturbed mental status.</p> Signup and view all the answers

    What is the early symptom of vascular cognitive impairment?

    <p>Memory loss</p> Signup and view all the answers

    Explain the role of MRI in the diagnosis of VCI.

    <p>MRI plays a role in the diagnosis of VCI by providing imaging of the brain, allowing for the detection of multiple small cerebral infarctions and lacunar infarctions.</p> Signup and view all the answers

    What is the genetic basis for Huntington's Disease?

    <p>Huntington's Disease is caused by a genetic mutation on chromosome 4. It is inherited in an autosomal dominant manner.</p> Signup and view all the answers

    Explain the rationale for the signs and symptoms of Huntington's Disease.

    <p>The signs and symptoms of Huntington's Disease, such as difficulty concentrating, memory lapses, depression, stumbling and clumsiness, and mood swings, are due to the breakdown of nerve cells in the brain and the deterioration of physical and mental capabilities, primarily affecting the basal ganglia.</p> Signup and view all the answers

    What is the consequence of ischemic brain tissue progressing to necrosis?

    <p>The consequence of ischemic brain tissue progressing to necrosis is the death of brain tissue, leading to permanent damage and loss of function.</p> Signup and view all the answers

    Describe the impact of plaque formation on the brain in Alzheimer's Disease.

    <p>Plaque formation in Alzheimer's Disease leads to the clumping of beta amyloid fragments, which form neurotoxic plaques. These plaques disrupt normal neuronal function, leading to cognitive decline.</p> Signup and view all the answers

    Describe the impact of tangles on the cells of the brain in Alzheimer's Disease.

    <p>In Alzheimer's Disease, tangles form in the cytoplasm of brain neurons. These tangles are made up of abnormal tau proteins, which are unable to hold microtubules together. As a result, the microtubules are destroyed and the neurons eventually undergo cell death.</p> Signup and view all the answers

    Describe the impact of Alzheimer's Disease on acetylcholine and nerve conduction in the brain.

    <p>In Alzheimer's Disease, the terminal axons do not produce enough acetylcholine, a neurotransmitter. This leads to a lack of communication between cells, as they are unable to 'talk' to each other. The overall impact is a disruption of normal brain function.</p> Signup and view all the answers

    Describe the altered anatomy of the brain in Alzheimer's Disease, including where it starts and how it progresses.

    <p>In Alzheimer's Disease, the pathology starts in the hippocampus, which is responsible for memory. From there, it spreads throughout the brain, affecting regions such as the frontal lobe (problem solving, judgment) and the limbic system (emotions). The progression of the disease leads to cerebral atrophy.</p> Signup and view all the answers

    Describe the underlying vascular problem in Vascular Cognitive Impairment (VCI).

    <p>Vascular Cognitive Impairment (VCI) is caused by a condition that blocks or reduces arterial blood flow to the brain, leading to a decline in thinking skills. The underlying vascular problem is progressive narrowing of the arteries, often due to atherosclerosis.</p> Signup and view all the answers

    Study Notes

    Dementia and Brain Confusion

    • Dementia is the impairment of memory, abstract thinking, judgment, and personality, and other higher cognitive functions, resulting in changes in personality and significant interference in work or social activities.
    • Confusion is an altered level of consciousness, disorientated to time, person, or place; disturbed mental status.
    • Dementia is more permanent and irreversible, while confusion is more reversible and helps correct the situation that has resulted in confusion.
    • Acute confusion workup: Hypothyroidism, side effect drugs, Heart Failure, Myocardial infarction, Depression, Dehydration & electrolyte imbalance, Alcohol abuse, Infections in the elderly, Anemia, Renal failure, Liver disease, Malnutrition, and Intracranial pathologies.

    Etiologies for Dementia/Chronic Confusion

    • 60% Alzheimer's Disease
    • 15% Lewy Body Dementia
    • 10% Mixed
    • 10% Other
    • 5% Vascular (Atherosclerosis)

    Lewy Body Dementia

    • Lewy Body Dementia (LBD) is a progressive brain disorder.
    • The neuron has trouble processing alpha-synuclein protein fragments.
    • Lewy bodies build up in brain tissues.
    • There is a decrease in the neurotransmitter Acetylcholine.
    • Result of misfolded proteins that collect in cytoplasm of neurons, destroy neurons, and affect communication, dementia, and behavior.

    Alzheimer's Disease

    • Compare memory issues of normal aging with Alzheimer's Disease:
      • Forget whole experiences
      • Rarely remember things later
      • Gradually unstable to follow written or spoken directions and make choices
      • Often get lost in familiar places
    • Number one risk factor: Age
    • Genetic defect: Chromosome 19
    • Plaque formation: Amyloid precursor protein on brain, cut in abnormal location, activates beta amyloid, and increases plaque.
    • Impact of plaque formation on brain: Beta amyloids clump together and form neurotoxic plaque.
    • Development of tangles: Tau should hold the microtubules together, but something stops that from happening, and they cells get tangled.
    • Impact of tangles on brain cells: Tau is abnormal, can't hold cells together, microtubules destroyed, tangles, neuron cell death.
    • Impact of AD on acetylcholine and nerve conduction: Terminal axons do not produce acetylcholine, no neurotransmitter, cells can't "talk" to each other, impact on normal brain function.
    • Altered anatomy: Starts in Hippocampus, impairment is an early symptom, up over and around the brain, goes to frontal lobe, problem solving, judgment, and limbic system, emotions, anger.
    • Diagnosis: Excludes all other etiologies or reasons for confusion or forgetfulness, general physician exam, Mini Mental State Examination, MRI or CT Scan shows cerebral atrophy and enlarged ventricles.
    • Definitive diagnostic test: Autopsy (rarely done)
    • Pharmacologic treatment: Cholinesterase inhibitors increase acetylcholine neurotransmitter, improve memory, Donepezil.

    Vascular Cognitive Impairment (VCI)

    • VCI is a decline in thinking skills caused by a condition that blocks or reduces arterial blood flow to the brain, depriving brain cells of O2 and other nutrients.
    • Underlying vascular problem: Atherosclerosis, progressive narrowing, sluggish blood clots, vessel injury, tear, neutrophils, monocytes, macrophage, LDL, foam cell, growth factors, intimal thickening, plaque, and ischemic tissues.
    • Early symptom: Memory loss
    • Role of MRI in diagnosis: Dementia R/T multiple small cerebral infarctions, MRI Lacunar infarction, subcortical (below cerebral infarction).

    Huntington's Disease

    • Huntington's Disease is an inherited disorder that causes nerve cells in parts of the brain to gradually break down and die.
    • Genetic basis: Chromosome 4, autosomal dominant, fetal, breakdown of nerve cells, brain deterioration of physical ability, basal ganglia, and mental capabilities.
    • Onset: Often between the ages of 30 and 50.
    • Rationale for signs and symptoms: Difficulty concentrating, memory lapses, depression, stumbling, clumsiness, and mood swings.

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