Recommended
More Related Content
Viewers also liked
Similar to Case study
Similar to Case study (20)
Recently uploaded
Recently uploaded (20)
Case study
- 1. Biochemistry 460/660 Case Study Alzheimer’s Disease Erica Hanson
- 2. Consider the Following Patient A 70 year old woman, Emily, comes into the doctor for an appointment. She has been repeating statements and questions, getting lost in familiar places, and having trouble remembering people and conversations. Emily has also been having mood swings, has become irritable, and has withdrawn from social activities.
- 3. What diagnosis would your initial diagnosis be for Emily?
- 4. What tests would you perform to bolster your diagnosis for Emily?
- 5. Alzheimer’s Disease A progressive disease that destroys memory and other important mental functions Caused by a combination of genetic, lifestyle, and environmental factors that affect the brain over time Most common cause of dementia Brain cells degenerate, die, and cause a steady decline in memory and mental function Results from plaques (beta-amyloid protein that interferes with cell-to-cell communication) and tangles (protein tau that makes the normal structure and functioning of brain cells)
- 6. Alzheimer’s Disease Risk increases after age 65 Women are more likely to get Alzheimer’s A gene contained in the extra chromosome in Down syndrome increases the risk of Alzheimer’s Memory and impaired judgement are some of the first functions affected Physical functions, like swallowing, balance, and bladder control can be affected as the diseases progresses
- 8. Diagnosing Alzheimer’s Disease measured by a physical exam Doctor will check overall neurological health by checking performing physical and neurological exam Physical tests include checking reflexes, muscle tone and strength, ability to get up from a chair and walk across the room, sense of sight and hearing, coordination, and balance Lab tests include blood tests to rule out other memory loss diseases, neuropsychological testing, and brain imaging (MRI, CT, etc.)
- 10. Plaques Result from Beta-amyloid protein Plaques form when these protein pieces clump together Beta-amyloid comes from a large protein found in the fatty membrane that surrounds nerve cells Chemically sticky so it can build up a plaque Small clumps that consist of a few beta-amyloid pieces are most damaging Block cell-to-cell synapses Activate immune cells to trigger inflammation and devour disabled cells
- 11. Beta-amyloid Glycoproteins deposited extracellularly in tissues in amyloidosis Made as cleavage products 39 to 43 amino acids in length from Amyloid Precursor Protein by proteases B-secretase and y- secretase Have hydrophilic N-terminal and hydrophobic C-terminal Assemble into fibrils and are insoluble
- 12. Tangles Destroy vital cell transport In healthy individuals, transport system should be organized in parallel strands by tau protein helping the tracks remain straight In Alzheimer’s individuals, tau collapses into twisted strands, known as tangles Tracks fall apart and disintegrate, so no nutrient movement through cells results in cell death
- 13. Tau Natively unfolded protein structure, gives the protein flexibility and ability to stabilize functional microtubules Primary structure is hydrophilic Has an acidic N-terminal, proline-rich middle, and neutral C-terminal Has a transient secondary structure of α-helices, β-pleated sheets, and a poly-proline II helix Forms aggregations with other tau proteins Phosphorylation state affects binding to microtubules to aid in their assembly and stabilize them Abnormality seen in Alzheimer’s when a phosphorylation of two serine- proline motifs occurs that leads to tangles
- 14. Treatment No cure Two types of drugs can treat cognitive symptoms Cholinesterase inhibitors treat agitation or depression Work by boosting levels of cell-to-cell communication by providing acetylcholine Memantine works in a brain cell communication network to slow the progression of symptoms
- 15. References http://www.mayoclinic.org/diseases-conditions/alzheimers- disease/symptoms-causes/dxc-20167103 https://www.alz.org/braintour/plaques.asp https://www.anaspec.com/products/productcategory.asp?id=908 http://www.proteopedia.org/wiki/index.php/Tau_protein https://www.google.com/url?sa=i&rct=j&q=&esrc=s&source=images&cd=&cad =rja&uact=8&ved=0ahUKEwjKoZbM1PnQAhXKjlQKHUJwCokQjRwIBw&url=http% 3A%2F%2Fwww.alz.org%2Ffacts%2F&psig=AFQjCNFGZa5n8oY8paHDGZQEFpF6S NM5Aw&ust=1482010260164231 https://www.google.com/url?sa=i&rct=j&q=&esrc=s&source=images&cd=&cad =rja&uact=8&ved=0ahUKEwjT2uSCw_rQAhVqyVQKHVz1A4kQjRwIBw&url=http %3A%2F%2Fwww.brightfocus.org%2Falzheimers%2Finfographic%2Famyloid- plaques-and-neurofibrillary- tangles&psig=AFQjCNFxMdS19dbuRSVYm1hzuRhUGk5o5Q&ust=1482039904623 879