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Alzheimers
Patho. exam 3
48
Nursing
10/29/2010

Additional Nursing Flashcards

 


 

Cards

Term
Dementia
Definition
Natural aging, may forget events or names but don't have problems with functions like dressing themselves, eating, brush teeth
Term
Alzheimers Disease
Definition

this is hard to diagnose when patients are living, lesions that destroy the brain, most common, 4th leading cause of death by disease, less than 1% of the cases are inherited

cerebral areas are thinning out, ventricles are larger, and areas that control memory, personality, abstract thinking are all affected

Term
early onset
Definition
less than 10% many have down syndrome
Term
Late onset
Definition

after the age of 65 50% of people 90 or above have this

 

 

Term
how much has it cost healthcare
Definition
Billions of dollars
Term
Stage 1
Definition
cognitive change is this stage- short term memory loss, problem with wound finding, forget names, may like to wear the same clothes every day.
Term
Stage 1
Definition
personality changes in this stage; become very passive, upset very quickly, or don't seem to care about anything
Term
Stage 1
Definition
functional changes at the stage; appear vague, they will get ready for church on a wednesday, or get up for work, should not be driving
Term
stage 2
Definition
cognitive changes at this stage- difficult time doing calculations, memorey recall is bad, more forgetful start to lose learned behavior
Term
Stage 2
Definition
Personality changes at this stage; self absorbed, lack of interest in surrounding
Term
Stage 2
Definition
Function at this stage; lose the ability to get dress, brushing teeth, sleep distrubances, neglect hygiene
Term
Stage 3
Definition
Cognitive changes at this stage; judgment is seriously flawed, ask the same quesitns over and over again
Term
 stage 3
Definition
 personality changes at this stage; disoriented to time and place, as the same questions, lethargic, hyperactivity
Term
Stage 3
Definition
functional changes at this stage; need lots of help with ADLs need protection and supervision at this point may begin to wander
Term
stage 4
Definition
Cognitive changes at this stage; unable to speak, can't read or write,dont see anyone familiar, can't even tell you who they are if they look in the mirror
Term
Stage 4
Definition
personalilty changes at this stage; hallucinations,can be very violent
Term
Stage 4
Definition
functional changes at this stage; total inability to care for themselves, may compulsively touch things, may not be able to use the bathroom at all, need to be supervised
Term

Diagnosis for Alzheimers

 

Definition
History, MRO, physcial exam, interview family, best way to tell is the autopsy after death
Term

Pathologic changes

(gross brain)

Definition
  • There is a decrease in the brains weight and thickness of the cortex, the cerebral cortex is atrophied
  • the white matter is shrunken
  • the ventricles are enlarged
Term

Pathologic changes

Loss of ACH

Definition
  • there is a loss of cholinergic neurons which affect the hyppocampal area first
  • next it effects occipital, frontal, parietal, temporal lobes
  • loss of cholinergic nueron results in loss of ACH and enzyme choline acetyltransferase.
Term
 loss of Cholinergic neurons
Definition
what affects the hippocampal area first?
Term
loss of ACh and the enzyme choline acetyltransferase (CAT)
Definition
loss of cholinergic neurons resluts in?
Term
Choline acetyltransferase (CAT)
Definition
this synthesizes AC; may be 50% less than normal
Term
ACh
Definition
this is a neurotransmitter required for commuication between cortical/neuronal cells
Term
Hallmarks of alzheimers
Definition
beta amyloid plaques, recognized in autopsy
Term
Beta amyloid plaques
Definition
this develops in ECF space and are found in the  hippocampus and other cognitive areas
Term
Beta amyloid plaques
Definition
this is aprotein that is snipped during metabolism from a larger protein called amyloid precursor protein, or APP
Term
APP (amyloid precursor protein)
Definition
transmembrane protein- normally it is snipped in the middle, but in alzheimers it is broken in the 40 and 42 amino acid
Term
40 amino acids
Definition
more soluble, generally not a problem, aggregates slowly
Term
42 amino acid
Definition
outside cell and more dangerous, less soluble, quickly aggregates, picks up dead neurons
Term
Neurofibrillary tangles
Definition
these are abnormal protein twisted into threads found inside the cell
Term
Tau
Definition
What is a major component of the neurofibrillary tangles?
Term
Tau
Definition

is known as a MAP which helps to stabilize the cells skeleton

is the key protein utilized in cellular transportation, is present in the normal brain

Term
Tau in Alzheimers
Definition
the cells cytoskelton takes on phosphorus and this becomes phosphorylated, develops tangles and is inable to provide stabilization from the cytoskeleton transport system breaks down-- energy balance is altered
Term
Neurofibrillary tangles
Definition
these are closely related to the degree of dementia a person with alzheimers exbits more so then the presence of amyloid plaques!
Term
Environmental factors
Definition
if we live long enough we may develop it, females are more likely to get it, down syndrome, patients why have had brain injuries, thyroid disorders
Term
1, 14,21,19
Definition
chromosomes that are effected?
Term
Chromosome 1
Definition
defective gene that may cause familial alzheimers, faulty protein synthesis
Term
Chromosome 14
Definition
familial alzheimers
Term
Chromosome 19
Definition
late onset of alzheimer, may inherit 2 copoes of ALP protein
Term
Cromosome 21
Definition
down syndrome, 3 copies, over production of APP
Term
Medication treatment
Definition
estrogen (ERT), anti-inflammaotry drugs, anti-oxidant drugs, cholinesterase inhibitors
Term
Estrogen (ERT)
Definition
protective properties, may delay onset, women have had this for 1 year post medapause had a decreased risk by almost 80% also comes with problems like cancer
Term
anti-inflammatory drugs
Definition
like ibprophen, NSAIDS, can decrease but there are no good studies, come with bad things too like infections, not healing as fast as they could
Term
Anti-oxidant drugs
Definition

selegiline -depranyal

vitamin E- evidience that is diminishes free radical damage

Term
Cholinesterase inhibitors
Definition

in alzheimers a deficiency of acidalcoline and throught that these owuld make more available ACH thought the help with the break down

 

exelon, aricept, cognex

Term
symptom management
Definition
be patient, reorientate ( let them know the day, weather, and whats going on in the day) avoid to much pressure on the patient, accommodate to changing moods, keep environment very simple, routines are very important, provide support
Term
research
Definition

beta amyloid aid in the transport of choline across cell membranes, AD patient exhibit deficiency of the NT choline- perhaps there is a link between the plaques and the dying off of chollinergic neurons

beta-amyloid plaques also may interrupt potassium channels that will affect calcium levels in cells- to much calcium in cells can lead to dealth