7 Flashcards
what drug can be given to prevent the peripheral breakdown of levodopa
Aromatic amino acid decarboxylase inhibitos-carbidopa
levodopa can be broken down by what
COMT
levodopa can be broken down by COMT so drugs such as
entacapone and tolcapone
how does gabapentin work
voltage dependent ca channels
how does pregabalin work
N type Ca2+ channels
how does carbamazepine work
blocks na and Ca2+ channels
when do you get a rest tremor
PD
when do you get an intention tremor
cerebellar damage eg MS, stroke
when do you get a postural/essential tremor
Autosomal dominant essential tremor
hyperthyroidism, anxiety, B agonists
what is pseudoathetosis caused by
severe proprioceptive loss
describe the Fried model for measuring frailty
1 point for each of unintentional weight loss low grip strength self-reported exhaustion low physical activity levels slow walking speed 0=not frail 1-2=pre-frail 3+=frail
describe the deficit accumulation (Rockwood)
take a large number of body systems 20-80
count how many have a deficit
index divided by total number of systems
number between 0-1
what is included in complex geriatric assessment
medical, functioning, social and environmental, psycholocgical
what is anterior spinothalamic tract
crude touch and pressure
lateral spinothalamic tract transmits what
pain and temperature
what happens to the first order neurones in the spinothalamic tract
they arise at sensory receptors in periphery, enter the spinal cord ascend 1-2 vertebral levels and synapse at the tip of the dorsal horn-substantia gelatinosa
at what point does the spinothalmic tract become two tracts
2nd order neurones-from substantia gelatinosa to thalamus-they decussate within the cord to form 2 tracts
DCML lesions can be seen in what deficiency
B12
what can help with neutropenia
G-CSFs eg filgrastim or lenograstim
left shift almost always refers to what type of cells
neutrophils
what do A delta fibres do
mechanical and thermal nociceptors that are thinly myelinated
they mediate first/fast pain
what do C fibres do in pain
they respond to all noxious stimuli
they are unmyelinated
mediate 2nd/slow pain
where does the sigmoid sinus drain into
the internal jugular vein
what are antibodies produced against in myasthenia gravis
acetylcholine receptors
what is lumbar the same as
para-aortic
what does deep peroneal nerve innervate
anterior compartment of the leg
tibialis anterior, extensor halluces longus, extensor digitorum longus, peroneus tertius, extensor digitoum brevis
what does the median aperture do
drain CSF into the cisterna magna
what is graft versus host disease
results from lymphocytic proliferation
donor lymphocytes sees the recipients lymphocytes as being foreign and can proliferate causing sever complications
what can happen to the platelet count as a result of transfusion reaction
thrombocytenia, tends to happen a few days after transfusion
what can happen to the calcium level in transfusion reactions
hypocalcaemia
which antibody can cause particular problems with transfusion reactions
IgA
what is Kleinfelters syndrome
47 XXY
primary features are sterility and small testicles
what is Kallmans syndrome
a genetic disorder preventing patient from starting and completing puberty
hypogonadotrophic hypogonadism
poorly defined secondary sexual characteristics, hypogonadism, infertile and increased risk of osteoporosis and decreased smell
what is the antagonist of Benzodiazepines
Flumazenil-benzos are fairly safe in overdose and unlikely to cause resp depression
what are some of the side effects of benzodiazepines
paradoxical aggression
anterograde amnesia and impaired coordination (esp Rohypnol)
how do benzos help anxiety
they decrease anxiety and aggression hypnosis/sedation muscle relaxation anticonvulsant effect anterograde amnesia
what does GABA cause
hyperpolarisation of cells
are benzos GABA agonists or antagonists
agonists
