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Medicine PJE > BB > Flashcards

BB Flashcards

1
Q

Genes Associated with Parkinson’s Disease

A

SNCA - Lewy Bodies

LRRK2 - most common (type of kinase)

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2
Q

Dopaminergic Pathways

A

o Mesocortical.
o Nigostriatal.
o Mesolimbic.

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3
Q

Dopaminergic Agonists:

A

Rotigotine: agonists which can be used as transdermal patch

Apomorphine: can be used as an infusion

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4
Q

MAOb Inhibitors

A

Rasagiline

Selegiline

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5
Q

Anticholinergic Compounds

A

Orphenadrine

Procyclidine

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6
Q

Amantadine

A

inhibits dopamine reuptake, increases dopamine release.

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7
Q

COMT Inhibitors

A

entacapone

tolcapone

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8
Q

Huntington’s Disease

A

Autosomal dominant disease

Changes in gene coding protein huntingtin on chromosome 4

Major loss of GABA-ergic striatal neurons and cortical atrophy

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9
Q

Parkinson’s Disease pathology

A

Loss of Dopaminergic cells in substantia nigra

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10
Q

Huntington’s Disease Treatment

A

Tetrabenazine: inhibitor of vesicular amine transporter (delete presynaptic dopamine -> less chorea)

Haloperidol, Olanzapine: antidopaminergic/antipsychotic drugs

Imipramine, Amitriptyline: antidepressant drugs.

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11
Q

Lenticulostriate arteries

A

Proximal part of MCA blood supply to the basal ganglia

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12
Q

Clasp-Knife Reflex

A

Resistance to arm extension until sudden stoppage of resistance

Particularly characteristic of chronic cerebral motor lesions.

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13
Q

Medulloblastoma

A

Most common malignant CNS tumour in children (tumour in 4th ventricle).

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14
Q

Nociceptors receptor proteins

A

TRPV1/2 open at high temperatures

TRPM8 open at very low temperatures.

ASIC3 is particularly present in skeletal and cardiac muscle: acid sensing- detect pH change with ischaemia.

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15
Q

Anterior vs Lateral spinothalamic tract in pain

A

AST moves arm.

LST causes response (i.e. to say “that hurts!”).

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16
Q

Anterior spinothalamic tract

A

These decussate to travel into the AST.

Innervate
a. Ventral posterior lateral, medial nuclei (VPL, VPM) of the thalamus –> Project to the primary somatosensory cortex (SI)
a) Localisation and physical intensity of the stimulus.
b. Ventral posterior inferior nuclei of the thalamus.
c. Central lateral (CL) of the thalamus –> Project to the anterior cingulate cortex.
a) Emotion/motivation)
CL –> Project to the prefrontal cortex and striatum.
a) Sites for cognitive function/strategy.
d. Somatosensory thalamus –> Project to the secondary somatosensory cortex.

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17
Q

Lateral spinothalamic tract

A

Mainly C fibres but also some alpha delta fibres innervate projection neurons in lamina I

  1. These decussate to travel into the LST.
  2. The innervate more posterior/medial parts of the thalamus.
    a. Mediodorsal Nucleus (ventrocaudal) i.e. MDvc –> Project to the anterior cingulate cortex (ACC)
    b. Posterior Thalamus (Posterior Nucleus and Ventral Medial Nucleus) –> Project to the anterior or rostral insula - Emotion, quality (i.e. pain), autonomic integration)
18
Q

Prostaglandin synthesis

A

Phospholipase A2 releases Arachidonic Acid (AA) from cell membranes (due to inflammatory mediators)

COX1 and COX 2 use AA as a substrate for PG synthesis

COX-1 is normally present, COX-2 induced during inflammation

19
Q

Circuitry of Cognitive and Emotional Control of Pain

A

Intensity: superior parietal lobe –> insula –> amygdala path (attention control) –> PAG.

Unpleasantness: ACC –> PCC –> PAG

20
Q

Morphine Mechanism

A

Decreased excitability and decreased release of neurotransmitters.
o Due to activation of K+ conductance and decreased Ca2+ conductance.

21
Q

NSAIDs (COX-2 inhibition)

A

Aspirin:
COX-1 and COX-2 inhibitor (also anti-inflammatory)

Ibuprofen, diclofenac, ketoprofen:
COX1/COX2 and additional mechanisms

Rofecoxib: selective COX-2 inhibitors.

22
Q

Anticonvulsant Drugs (non-opioid)

A

Carbamazepine (acts on sodium channels)

Sodium Valproate (acts on sodium channels).

Pregabalin (acts on alpha2delta subunit)

23
Q

Tricyclic Antidepressants (non-opioid)

A

Amitriptyline (inhibit reuptake of amines, block Na+ and Ca2+ channels).

24
Q

Calcium channel ligands

A

gabapentin
pregabalin
verapamil

25
Q

Opioid agonists

A

Tramadol

26
Q

Medication that blocks sodium channels

A

lignocaine

prilocaine

27
Q

Chandelier cells

A

Special population of interneurons which are GABAergic cells
o Control the activity of cortical pyramidal cells by synapsing on the axonal initial segment.

The loss of inhibitory CC increases the risk of abnormal excitatory activity

28
Q

Phenytoin

A

stabilises the inactivated state of channels

DO NOT USE IN ABSENCE SEIZURES.

29
Q

Carbamazepine

A

stabilises the inactivated state of channels.

DO NOT USE IN ABSENCE SEIZURES.

30
Q

Sodium Valproate

A

Used in all types of seizures

31
Q

Lamotrigine

A

presynaptic inhibition of glutamate release

32
Q

Topiramate

A

increases GABA transmission and inhibits glutamate (/AMPA which mimics glutamate).

33
Q

Lacrosamide

A

binds to inactivated state of channels.

34
Q

Benzodiazepines (GABAa Receptor)

A

Clonazepam:

sedation

35
Q

Barbiturates (GABAa Receptor)

A

Phenobarbitone

36
Q

Calcium Channels

A

Zonisamide:
blocks calcium channels

Ethosuximide: used in absence seizures
• Blocks T-type calcium channels.

Gabapentin (Pregabalin): blocks alpha2delta2 subunit of calcium channels.
• Pregabalin also increases GABA levels

37
Q

Neurotransmitter Release

A

Levetiracetam:

bonds to synaptic protein SV2a

38
Q

Neurotransmitter Uptake

A

Tiagabine:

Inhibits GAT-1 transporter for GABA

39
Q

Neurotransmitter Synthesis

A

Vigabatrin:

inhibition of GABA transaminase, therefore protection of GABA

40
Q

Neurotransmitter Receptors.

A

Perampanel:
selective non-competitive antagonist of AMPA receptors

Felbamata:
NDMA receptors.

Medicine PJE (7 decks)

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