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Neuropathology II - Demyelination & Dementia

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Neuropathology II - Demyelination & Dementia given in Week 4 Includes Memory Loss lectures given during Week 4
Matthew Coulson
Quiz by Matthew Coulson, updated more than 1 year ago
Matthew Coulson
Created by Matthew Coulson about 6 years ago
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Resource summary

Question 1

Question
What is the most common demyelinating disease? [blank_start]Multiple Sclerosis[blank_end]
Answer
  • Multiple Sclerosis

Question 2

Question
Multiple sclerosis is more prevalent in women than men
Answer
  • True
  • False

Question 3

Question
The peak incidence for diagnosis of Multiple Sclerosis is ...
Answer
  • 13-18 years old
  • 20-30 years old
  • 40-50 years old
  • >50 years old

Question 4

Question
The demyelination associated with MS is best seen on which type of brain scan?
Answer
  • T1 MRI Brain Scan
  • T2 MRI Brain Scan

Question 5

Question
Demyelinating plaques in MS typically affect the ...
Answer
  • white matter of the brain
  • grey matter of the brain
  • meningeal-cerebral border

Question 6

Question
What type of tumour tend to typically arise at the cerebellopontine angle? [blank_start]Vestibular schwannoma[blank_end]
Answer
  • Vestibular schwannoma

Question 7

Question
One way of diagnosing MS is via lumbar puncture looking for oligoclonal [blank_start]IgG[blank_end] bands in the CSF
Answer
  • IgG
  • IgA
  • IgE

Question 8

Question
Dementia occasionally occurs as part of the natural ageing process and is not considered pathological.
Answer
  • True
  • False

Question 9

Question
What is the most common subtype of dementia?
Answer
  • Alzheimer's Disease
  • Vascular Dementia
  • Dementia with Lewy Bodies
  • Frontotemporal Dementia

Question 10

Question
Alzheimer's Disease affects 2x more women than men
Answer
  • True
  • False

Question 11

Question
Alzheimer's Disease has a higher incidence in Trisomy 21 (Down's Syndrome) patients
Answer
  • True
  • False

Question 12

Question
One of the mot prominent macroscopic features of Alzheimer's Disease is the cortical atrophy. Which 3 lobes tend to be most heavily affected by this?
Answer
  • Frontal lobe
  • Temporal lobe
  • Parietal lobe
  • Occipital lobe
  • Lacunar lobe

Question 13

Question
Looking at the slices shown here, which of the brains is most likely to have had Alzheimer's Disease?
Image:
Picture50 (binary/octet-stream)
Answer
  • 1
  • 2
  • 3

Question 14

Question
Neurofibrillary tangles are typical of Alzheimer's Disease. They typically occur in the [blank_start]temporal[blank_end] lobe and [blank_start]hippocampus[blank_end] (memory centre) and are associated with the [blank_start]Tau[blank_end] protein.
Answer
  • Tau
  • temporal
  • hippocampus

Question 15

Question
Alzheimer's Disease patients also show Neuritic Plaques in the brains. These are plaques surrounding astrocytes and microglia, composed of what type of amyloid?
Answer
  • Amyloid beta peptide (Aβ)
  • Serum amyloid A
  • Amyloid delta peptide (Aδ)
  • Amyloid gamma peptide (Aγ)

Question 16

Question
The reason Alzheimer's is more prevalent in Down's Syndrome is due to the fact that the protein cleaved to form amyloid beta peptide is on the 21st chromosome. Having three of these makes accumulation of beta amyloid more probable.
Answer
  • True
  • False

Question 17

Question
Amyloid beta protein is formed by the cleavage of ...
Answer
  • Amyloid precursor protein
  • Amyloid progenitor protein
  • Amyloid forming protein
  • Amyloid catalysing protein

Question 18

Question
In terms of histology, which stain is used to best identify beta amyloid peptides, thus aiding a diagnosis of Alzheimer's Disease?
Answer
  • Congo Red
  • Hematoxylin
  • Carmine
  • Methyl Blue
  • Methyl Green
  • Toluidine Blue
  • Orange G
  • Aniline Blue

Question 19

Question
Which 3 of the following symptoms are important in differentiating Dementia with Lewy Bodies (DLB) from Alzheimer's Disease?
Answer
  • Difficulty walking and a decrease in balance. Typical Parkinsonism symptoms
  • Visual hallucinations
  • Headache
  • Fluctuations in memory loss
  • Moodswings

Question 20

Question
Parkinsonism usually occurs due to damage to which part of the basal ganglia? [blank_start]Substantia Nigra[blank_end]
Answer
  • Substantia Nigra

Question 21

Question
Which type of dementia is also due to degeneration of the substantia nigra?
Answer
  • Dementia with Lewy Bodies
  • Alzheimer's Disease
  • Huntington's Disease
  • Frontotemporal Dementia
  • Vascular Dementia

Question 22

Question
Which two of the following proteins tend to accumulate in Dementia with Lewy Bodies?
Answer
  • ∝-Synuclein
  • Ubiquitin
  • Tau
  • Amyloid Beta
  • Apolipoprotein
  • ITM2B
  • Glial Fibrillary Acidic Protein

Question 23

Question
The gene known to cause the autosomal dominant Huntington's disease is called [blank_start]Huntingtin[blank_end]
Answer
  • Huntingtin

Question 24

Question
Huntington's disease typically causes the greatest extent of atrophy in which of the following basal ganglia structures?
Answer
  • Caudate Nucleus
  • Putamen
  • Globus Pallidus

Question 25

Question
Pick's Disease is also known as ...
Answer
  • Frontotemporal Dementia
  • Vascular Dementia
  • Creutzfeldt-Jakob Dementia

Question 26

Question
Which of the 3 following symptoms are most common in Fronto-Temporal Dementia
Image:
Picture51 (binary/octet-stream)
Answer
  • Fluctuating memory loss
  • Parkinsonism-like symptoms (gait problems, loss of balance, etc)
  • Personality and behavioural change
  • Speech and communication problems
  • Changes in eating habits
  • Sensory weakness in face and arms
  • Sensory weakness in legs

Question 27

Question
The inability to recognise objects seen as part of Alzheimer's Disease is known as [blank_start]Agnosia[blank_end]
Answer
  • Agnosia

Question 28

Question
Two or more of the following symptoms is diagnostic of which type of dementia? Visual hallucinations Fluctuating cognition (delirium-like) REM sleep behaviour disorder Parkinsonism (not more than 1 year prior to onset of dementia) Positive DAT scan
Answer
  • Dementia with Lewy Bodies
  • Vascular Dementia
  • Frontotemporal Dementia
  • Alzheimer's Dementia

Question 29

Question
What is the first line scanning modality for someone suspected of dementia?
Answer
  • CT Scan
  • MRI Scan
  • SPECT
  • DAT Scan

Question 30

Question
Which imaging modality is most useful for frontotemporal dementia?
Answer
  • CT Scan
  • MRI Scan
  • SPECT Scan
  • DAT Scan

Question 31

Question
Which imaging modality is most useful for clarifying Parkinsons Plus Syndromes such as Dementia with Lewy Bodies?
Answer
  • CT Scan
  • MRI Scan
  • SPECT Scan
  • DAT Scan

Question 32

Question
A 86 year old woman presents to her GP which her daughter, who complains that her mother has had progressive memory loss over the past 3 months. Her mother also complains that she has been seeing spiders crawling up the walls of her apartment and has recently developed a tremor in her hands. What type of dementia is she likely to have?
Answer
  • Dementia with Lewy Bodies
  • Frontotemporal
  • Alzheimer's Disease
  • Vascular Dementia

Question 33

Question
What is the first line medical treatment for Alzheimer's Disease?
Answer
  • Cholinesterase Inhibitors
  • Antipsychotics
  • Antidepressants
  • Dopamine Receptor Inhibitors
  • Glutamatergic Inhibitors

Question 34

Question
Which of the below mentioned drugs is an example of a Cholinesterase Inhibitor used to treat Alzheimer's Disease?
Answer
  • Donepezil
  • Loxapine
  • Thiothixene
  • Fluphenazine
  • Mesopezil

Question 35

Question
If an Alzheimer's/DLB patient fails on Anticholiniergics, or diagnosed with moderate/severe dementia, what drug should they be prescribed? [blank_start]Memantine[blank_end]
Answer
  • Memantine

Question 36

Question
It is not mandatory to report a dementia diagnosis to the DVLA
Answer
  • True
  • False

Question 37

Question
In terms of memory loss: [blank_start]Anterograde Amnesia[blank_end] - difficulty in acquiring new material and remembering events since the onset of the illness or injury. [blank_start]Retrograde Amnesia[blank_end] - difficulty in remembering information prior to the onset of the illness or injury
Answer
  • Retrograde Amnesia
  • Anterograde Amnesia

Question 38

Question
Creutzfeldt–Jakob disease is a fatal degenerative brain disorder. It causes memory loss, visual disturbances, blindness and is believed to be caused by the protein [blank_start]Prion[blank_end]
Answer
  • Prion
  • Tau
  • Synuclein
  • Beta amyloid
  • Presenilin 2
  • Amyloid Precursor Protein

Question 39

Question
A 67 year old women on Ward 2 of Ninewells, admitted for a UTI, has a 3 day history of memory loss and fluctuating cognition. She is not orientated to time or place. It is likely she is suffering from [blank_start]Delirium[blank_end]
Answer
  • Delirium

Question 40

Question
Visual hallucinations are common in [blank_start]Delirium[blank_end]
Answer
  • Delirium
  • Dementia
  • Depression
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