Parkinson's Disease
Huntington's Disease
Alzheimer's Disease
Case Studies and Other
Mood Disorders
100
The degeneration of this area of the brain causes PD.
Substantia nigra
100
What percentage of HD cases are genetic?
100% genetic
100
Which amnesia(s) are associated with advanced AD?
Retrograde and anterograde amnesia.
100
What is a concordance rate?
The degree to which a disease is determined by genetics. You often hear concordance rates being talked about with regards to twins. For example, HD has a concordance rate of 100% and PD of 1%.
100
What might hypothyroidism be misdiagnosed as?
Depression
200
What is the cause of PD?
99% environmental exposure to MPTP-like compounds. 1% genetics.
200
What is the treatment for HD?
There is no treatment.
200
Name a histological feature that contributes to the symptoms of AD. Which compound can bind to this feature? (Very, very promising diagnostic opportunity!)
Dense plaques, Pittsburgh compound B
200
What did Jeremy develop after experiencing convulsions? What did this mean for his day-to-day life?
Anterograde amnesia. He cannot remember his day-to-day life! He needs to record his phone conversations and likes/dislikes of friends. Needs a watch to remind him of where he is going, etc.
200
What do antidepressants do?
Facilitate neurogenesis, decrease the amount of serotonin in the brain. NOTE: Was previously thought that serotonin levels are decreased in depressed patients, but evidence suggests they may be increased. SSRIs, the studies say, actually can make things worse, and if they do work, it is just because they jumped the body's compensatory mechanisms to lower serotonin levels into gear... so, they actually increase serotonin, but also do contribute to neurogenesis
300
Why is degeneration limited to one area of the brain in PD?
MPTP-like chemicals are only converted to the toxic MPP+ in the presence of the enzyme monoamineoxidase-B, which is present only in the substantia nigra of primates (humans included).
300
Generally, what word could be used to describe the symptoms of HD? Why is this so? Is cognition intact?
Hyperkinesia. HD is caused by damage to the D2 pathway of the basal ganglia, which is the pathway responsible for termination of movement. If termination is affected, too much movement can occur. Additionally, concentration was impaired (woman could not count backwards by 7).
300
Name three types of memory that can be affected after damage to the hippocampus.
1) Working memory, like remembering a list of items to buy at the grocery store, 2) Memory for new facts, like in anterograde amnesia, 3) Spatial memory, because the hippocampus holds place cells
300
What happened to HM? Which part of his memory was intact, and which was faulty?
His hippocampi were removed to stop seizures. His memory of the distant past was intact (no retrograde amnesia), but he could not form new memories (had anterograde amnesia).
300
What does the release of CRF lead to?
The conversion of POMC to ACTH in the anterior pituitary. ACTH leads to the production of cortisol, which leads to increased utilization of glucose. It also shuts off nonessential systems. ACTH can lead to cell death in the hippocampus, impairing the expression of emotion and memory.
400
PD symptoms can be summarized as ____ with intact ___, because there is decreased _____(neurotransmitter) in the ____ pathway of the ______(brain structure), which _______ movement.
hypokinesia, cognition, dopamine, D1, basal ganglia, initiates
400
What would be the best way to test for HD?
Genetic test
400
Name one example of Helen's anterograde amnesia, and one example of her retrograde amnesia.
(Multiple answers acceptable) Anterograde amnesia: could not remember the play she went to the night before, could not remember where she was. Retrograde amnesia: could not remember her last name, could not remember her roses or her favorite songs/movie
400
How was George's recovery?
George was an individual who injected MPTP. He had a fetal brain transplantation. The procedure took 2 years to produce results, but was incredibly effective. However, George never regained use of his facial muscles.
400
How can anxiety be passed on to the baby? Why does this happen?
Maternal stress increases cortisol levels, which increase the size of the right amygdala. This part of the brain processes emotions, therefore increasing the risk of anxiety and depression.
500
What would be the ideal treatment for a patient in their upper 50s-early 60s with PD? Why is this treatment ideal? What are the risks associated with this treatment?
Deep brain stimulation. The treatment is affordable, effective, and immediate. However, during the procedure, there is risk of surgical complications, including internal bleeding if a blood vessel is nicked.
500
Specifically, what is the cause of HD? Explain at the genetic and protein level.
CAG repeats. More repeats = more severe, earlier age of onset. This gene is transcribed into mutant Huntingtin protein.
500
How does memantine differ from previous AD drugs?
Memantine is a partial NMDA receptor antagonist, while other drugs are either acetylcholinesterase inhibitors or full calcium channel blockers. Memantine stops the progression of AD. Previous drugs merely increased attention and motivation. Memantine can be used long-term, while previous drugs were only effective short-term. For instance, acetylcholinesterase inhibitors are only effective for 4-6 weeks.
500
A patient comes in for what looks like generalized anxiety. What, other than anxiety, could be causing these symptoms? We identified two possibilities in class. (Other than substance abuse)
1) Caffeinism, 2) Pin worms
500
Physiologically, happens to the brain during times of prolonged stress that are undesirable?
Nonessential systems are shut off, including the reproductive and immune systems. Neurogenesis cannot occur in the hippocampus, leading to a loss of neurons. Risk of developing anxiety and depression increases.
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