PATHOPHARMACOLOGICAL
FOUNDATIONS. EXAM 2025 QUESTIONS
AND ANSWERS
What are some physical changes from Alzheimer's dementia? - ANS - Brain shrinks
dramatically; nerve cell death and tissue loss
- Cardinal signs: plaques (abnormal clusters of protein fragments) and tangles (twisted strands
of another protein)
How is Alzheimer's treated? - ANS - There is no cure, but there are pharmacological and non-
pharmacological treatments
- Cholinesterase inhibitors
- Memantine (namenda)
What are cholinesterase inhibitors prescribed for? - ANS - To treat symptoms related to
memory, thinking, language, judgment, and other processes
- Helps delay or slow the worsening of symptoms
What does cholinesterase inhibitors do? - ANS - Prevent the breakdown of acetylcholine, a
chemical messenger that is important for learning and memory
- Supports communication among nerve cells by keeping the acetylcholine high
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, What are some commonly prescribed cholinesterase inhibitors? - ANS - Donepezil (aricept)
- Galantamine (razadyne)
- Rivastigmine (exeleon)
Which cholinesterase inhibitor can be used for all stages of Alzheimer's? - ANS - Donepezil
(aricept)
Which cholinesterase inhibitor can be used for mild-to-moderate stages of Alzheimer's? -
ANS - Galantamine (razadyne)
- Rivastigmine (exeleon)
Which cholinesterase inhibitor can be used for mild-to-moderate Alzheimer's and Parkinson's? -
ANS - Rivastigmine (exeleon)
What medication combination is used to treat moderate-to-severe Alzheimer's? - ANS -
Memantine (namenda) and donepezil (aricept)
What is memantine (namenda) used for? - ANS - Prescribed to improve memory, attention,
reason, language, and the ability to perform simple tasks
- Can be used alone or with other Alzheimer's disease treatments
How does memantine (namenda) work? - ANS - Regulates the activity of glutamate, a
chemical involved in information processing, storage, and retrieval
- Improves mental functioning and ability to perform daily activities for some people
What is the difference in MOA between cholinesterase inhibitors and memantine (namenda)? -
ANS - Cholinesterase inhibitors prevent the breakdown of acetylcholine, whereas
memantine (namenda) regulates the activity of glutamate
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, What is ataxia? - ANS - Also known as cerebellum attacks
- Degenerative disease of the nervous system
- Many symptoms mimic those of being drunk (i.e. slurred speech, stumbling, falling, and
incoordination)
What causes the symptoms of ataxia? - ANS - The damage caused to the cerebellum, the part
of the brain that is responsible for coordinating movements
- Can also be caused by damage to part of the spinal cord and nerves
What is the treatment for ataxia? - ANS - No treatment
- In some cases, treating the underlying causes (i.e. stopping medications that cause ataxia)
- In other cases, it is a result from chicken pox or other viral infections (likely to resolve on its
own)
- Genetic causes/predisposed disposition is usually chronic
What causes ataxia in the pediatric population? - ANS - Genetic predisposition
- Fragile X-Associated Tremor/Ataxia Syndrome (FXTAS)
- Prader-Willie Syndrome
What is Fragile X syndrome (FXS)? - ANS - A genetic condition inherited from parents which
results in various developmental problems
- Rare, but may be dangerous or life-threatening
- Present at birth and is a lifelong condition
- Rarely requires lab testing or imaging
- Often linked to autism (1/3 do have autism)
- X-linked disorder
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, Since Fragile X Syndrome (FXS) is an X-linked disorder, does a specific gender have a greater
risk? - ANS - Often, females are carriers and males are affected
- However, both males and females can be carriers, and both can be affected by the condition
- Usually milder in females
How did Fragile X Syndrome (FXS) get its name? - ANS - The gene Fragile X (the FMR1 gene) is
on the X syndrome
- Mutation of the FMR1 gene
What is the difference between Fragile X-Associated Tremor/Ataxia Syndrome (FXTAS) and
Fragile X Syndrome (FXS)? - ANS - Both caused by mutations on the FMR1 gene, but they are
caused by different changes in this gene
- FXS is caused by a full mutation
- FXTAS is a premutation
- FXS is present at birth, but display these features in early life
- FXTAS develops in adulthood (usually after age 50) and the symptoms may appear slowly and
develop over the years
- FXTAS individuals are usually healthy with normal cognitive skills prior to the onset
How is Fragile X-Associated Tremor/Ataxia Syndrome (FXTAS) diagnosed? - ANS - Being a
FMR1 premutation carrier
- The appearance of neurological features such as ataxia (balance problems), tremors, and
other symptoms
- MRI findings (changes in the brain)
What is Prader-Willie Syndrome? - ANS - Genetic disorder that affects many parts of the
body and their growth
- Causes mental and behavioral problems
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- Can be dangerous or life threatening if untreated
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