OCCTH 585 Test 2 UPDATED ACTUAL
Exam Questions and CORRECT Answers
Dementia is an umbrella term that includes what 4 neurological diseases? - CORRECT
ANSWER - Alzheimer's disease
Vascular dementia
Frontotemporal dementia
Lewy Bodies
What are 4 characteristics of Alzheimer's disease (AD)? - CORRECT ANSWER - •Not a
process of accelerated brain aging
•Specific characteristics in neurons
•Insidious onset (if someone has changes in a day or 2 it is not AD)
•cognitive and behavioral impairments; personality changes
AD early signs - CORRECT ANSWER - - memory loss
- misplacing items often
- mood changes without any stimulation
- should have issues with normal ADL tasks
- vision -- visual tract from frontal, temporal to occipital -- can affect visual tract (perception) not
peripheral vision more the central visual processing
- struggling to communicate (frontal dementia - broca area) -- trouble expressing ideas
- clients still have insight to these changes in the beginning
- poor judgment
- confusion of time and place
- social withdrawal
In people with AD, dendritic changes and neurocortical degeneration is resulting from what 3
main causes? - CORRECT ANSWER - 1) Neuritic plaques (Senile plaques) (β-amyloid) -
appears in normal aging - but would expect more in AD
,- Develop in the parenchyma of the brain
- Not strictly intraneuronal, extracellular structures
- Extracellular deposits of amyloid beta in the grey matter of the brain
2) Neurofibrillary tangles (tau)
- tau protein
- Strictly intraneuronal
- Lead to the death of neuron
- Specific to AD
3) Due to abnormality in the metabolism of two distinctive proteins
Beta amyloid plaques - CORRECT ANSWER - occurs in normal aging --especially over
the age of 80 -- not a big difference of people with AD vs normal aging brain -- however may
have a lower prevalence rate and lower number of plaques
discrete spherical lesions
consist mostly of beta amyloid peptide or amyloid plaques
how does B-amyloid plaques form? - CORRECT ANSWER - -Defective breakdown of a
benign substance known as amyloid precursor protein (APP), integral membrane protein
concentrated in the synapses of neurons
(occurs outside of the neurons)
-Produce sticky insoluble shards of β-amyloid plaques -> stick together (form clusters), form
dense plaques, -> damage axons
Which lobe is most severely affected by plaques? - CORRECT ANSWER - temporal
,Hippocampus volume is reduced by up to ____% in advanced AD (reduced connectivity of the
hippocampus with other brain areas)
And the volume of the Amygdala in Advanced AD is reduced by ____% - CORRECT
ANSWER - 60%
45%
hippocampus =____________ memory - people with degeneration in the hippocampus have
issues with this and spatial navigation - CORRECT ANSWER - episodic
how does Neurofilbrillary tangles occur in AD? - CORRECT ANSWER - - for some
reason there is degeneration of the Tau protein that regulates the assembly of microtubules (of
the axon) and stabilizes their structure
- the neurofibers (of the microtubules no longer held together) then start to tangle together
forming a bundle of filaments called a helix or neurofilbrillary tangle
(picture a strand of hair with multiple split ends that forms a messy knot or clump of hair)
In moderate stage of AD, the person will have some confusion from the deterioration of the
_______ and emotional changes due to its affect on the _________ of the limbic system. -
CORRECT ANSWER - SCN (Suprachiasmatic nucleus) located in the hippocampus
region and directly above the optic chiasm, controls the circadian clock rhythms (day-night
cycle);
amygdala
In AD, you will see _________ neurons destroyed. These neurons form the track that sends
messages via the neurotransmitter acetylcholine from the Nucleus basalis (bottom of frontal
lobe) to other cortical areas of the brain. In AD, the Nucleus Basalis is reduced by 70%! This
reduction of neurotransmitter in the brain has an impact on processing speed and response, etc. -
CORRECT ANSWER - cholinergic
, What is brain atrophy? - CORRECT ANSWER - cortical shrinkage and enlarged ventricles
of the brain causes issues with processing information
- this accelerates as the disease progresses
- not evenly distributed
- mostly in the gyri of association areas
90% of AD is late onset, around the age of ____ and has no known genetic cause - CORRECT
ANSWER - 65 (risk doubles every 5 years after this age)
History of what 3 things may increase your risk of AD? - CORRECT ANSWER - - head
injury (neuronal secretion of amyloid plaques / speed up the production of amyloid protein)
- depression
- ECT treatments
which is the most prevalent form of dementia? least? - CORRECT ANSWER - AD = 50-
70% of all cases
VD = 15-20%
Lewy Bodies = 10-20% (75-80 years old)
Frontotemporal = 5%
Frontotemporal Dementia - CORRECT ANSWER - As the name suggests, causes
degeneration of the frontal and temporal lobes (i.e. cortico-basal areas, frontal/anterior temporal
lobes, striatum, broca's area = expressive speech, Wernicke's area = receptive speech).
- It is primarily progressive aphasia and can occur at a young age.
- Plaques are not typically seen in this type.
- Symptoms can include change in character and social conduct (mood swings), speech
problems, Affect changes (poor motivation, indifference, flat affect)
Exam Questions and CORRECT Answers
Dementia is an umbrella term that includes what 4 neurological diseases? - CORRECT
ANSWER - Alzheimer's disease
Vascular dementia
Frontotemporal dementia
Lewy Bodies
What are 4 characteristics of Alzheimer's disease (AD)? - CORRECT ANSWER - •Not a
process of accelerated brain aging
•Specific characteristics in neurons
•Insidious onset (if someone has changes in a day or 2 it is not AD)
•cognitive and behavioral impairments; personality changes
AD early signs - CORRECT ANSWER - - memory loss
- misplacing items often
- mood changes without any stimulation
- should have issues with normal ADL tasks
- vision -- visual tract from frontal, temporal to occipital -- can affect visual tract (perception) not
peripheral vision more the central visual processing
- struggling to communicate (frontal dementia - broca area) -- trouble expressing ideas
- clients still have insight to these changes in the beginning
- poor judgment
- confusion of time and place
- social withdrawal
In people with AD, dendritic changes and neurocortical degeneration is resulting from what 3
main causes? - CORRECT ANSWER - 1) Neuritic plaques (Senile plaques) (β-amyloid) -
appears in normal aging - but would expect more in AD
,- Develop in the parenchyma of the brain
- Not strictly intraneuronal, extracellular structures
- Extracellular deposits of amyloid beta in the grey matter of the brain
2) Neurofibrillary tangles (tau)
- tau protein
- Strictly intraneuronal
- Lead to the death of neuron
- Specific to AD
3) Due to abnormality in the metabolism of two distinctive proteins
Beta amyloid plaques - CORRECT ANSWER - occurs in normal aging --especially over
the age of 80 -- not a big difference of people with AD vs normal aging brain -- however may
have a lower prevalence rate and lower number of plaques
discrete spherical lesions
consist mostly of beta amyloid peptide or amyloid plaques
how does B-amyloid plaques form? - CORRECT ANSWER - -Defective breakdown of a
benign substance known as amyloid precursor protein (APP), integral membrane protein
concentrated in the synapses of neurons
(occurs outside of the neurons)
-Produce sticky insoluble shards of β-amyloid plaques -> stick together (form clusters), form
dense plaques, -> damage axons
Which lobe is most severely affected by plaques? - CORRECT ANSWER - temporal
,Hippocampus volume is reduced by up to ____% in advanced AD (reduced connectivity of the
hippocampus with other brain areas)
And the volume of the Amygdala in Advanced AD is reduced by ____% - CORRECT
ANSWER - 60%
45%
hippocampus =____________ memory - people with degeneration in the hippocampus have
issues with this and spatial navigation - CORRECT ANSWER - episodic
how does Neurofilbrillary tangles occur in AD? - CORRECT ANSWER - - for some
reason there is degeneration of the Tau protein that regulates the assembly of microtubules (of
the axon) and stabilizes their structure
- the neurofibers (of the microtubules no longer held together) then start to tangle together
forming a bundle of filaments called a helix or neurofilbrillary tangle
(picture a strand of hair with multiple split ends that forms a messy knot or clump of hair)
In moderate stage of AD, the person will have some confusion from the deterioration of the
_______ and emotional changes due to its affect on the _________ of the limbic system. -
CORRECT ANSWER - SCN (Suprachiasmatic nucleus) located in the hippocampus
region and directly above the optic chiasm, controls the circadian clock rhythms (day-night
cycle);
amygdala
In AD, you will see _________ neurons destroyed. These neurons form the track that sends
messages via the neurotransmitter acetylcholine from the Nucleus basalis (bottom of frontal
lobe) to other cortical areas of the brain. In AD, the Nucleus Basalis is reduced by 70%! This
reduction of neurotransmitter in the brain has an impact on processing speed and response, etc. -
CORRECT ANSWER - cholinergic
, What is brain atrophy? - CORRECT ANSWER - cortical shrinkage and enlarged ventricles
of the brain causes issues with processing information
- this accelerates as the disease progresses
- not evenly distributed
- mostly in the gyri of association areas
90% of AD is late onset, around the age of ____ and has no known genetic cause - CORRECT
ANSWER - 65 (risk doubles every 5 years after this age)
History of what 3 things may increase your risk of AD? - CORRECT ANSWER - - head
injury (neuronal secretion of amyloid plaques / speed up the production of amyloid protein)
- depression
- ECT treatments
which is the most prevalent form of dementia? least? - CORRECT ANSWER - AD = 50-
70% of all cases
VD = 15-20%
Lewy Bodies = 10-20% (75-80 years old)
Frontotemporal = 5%
Frontotemporal Dementia - CORRECT ANSWER - As the name suggests, causes
degeneration of the frontal and temporal lobes (i.e. cortico-basal areas, frontal/anterior temporal
lobes, striatum, broca's area = expressive speech, Wernicke's area = receptive speech).
- It is primarily progressive aphasia and can occur at a young age.
- Plaques are not typically seen in this type.
- Symptoms can include change in character and social conduct (mood swings), speech
problems, Affect changes (poor motivation, indifference, flat affect)
