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REVISION EXTRAS > BLOCK 12 > Flashcards

BLOCK 12 Flashcards

1
Q

what is epilepsy? and what is the diagnostic criteria?

A

A chronic disorder of the brain that predisposes you to recurrent, unprovoked seizures. Usually diagnosed when an individual has 2 or more unprovoked symptoms >48 hrs apart

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2
Q

what the post-ictal phase?

A

Phase after the seizure where you typically have impaired conciousness

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3
Q

how are clonic and myoclonic seizures different?

A

myoclonic seizures are SO much faster. like every 0.2 seconds compared with every 2 seconds

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4
Q

what are the causes of seizures?

A 
Vascular -s troke/haemorrhage
Infections e.g. meningitis, encephalitis
Trauma or toxins e.g. drug abuse or alcohol withdrawal
Autoimmune e.g. lupus
Metabolic e.g. electrolyte disturbances
Idiopathic/epilspy 
Neoplasm
Syncope or psychogenic seizures
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5
Q

what are some medications that can trigger seizures?

A

antidepressants e.g. buproprion

isionizid

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6
Q

whats the first line drug for generalise seizures?

A

sodium valproate

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7
Q

whats the first line drug for focal seizures?

A

carbamazepine or lamotrigine

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8
Q

whats the first line drug for absence seizures?

A

ethosuximide

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9
Q

what drug is given to mothers with a diagnosis of eclampsia? why?

A

magnesium sulfate

it inhibits NMDA receptors, limiting the effect of glutamate

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10
Q

whats the - first line drug to give in hospital to stop a seizure?

A

Lorazepam - benzodiazepam

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11
Q

what age are febrile seizures most common?

A

6 months to 6 years

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12
Q

what infection do febrile seizures usualyl follow?

A

roseola virus - human herpes virus 6+7

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13
Q

what condition is closely related to epilepsy?

A

cerebral palsy

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14
Q

why should phenytoin, carbazmazpine and sodium valproate be carefully considered when a patient is on other meds too?

A

phenytoin and carbamazepine induce P450s actions

sodium valproate inhibits P450s action

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15
Q

what are some reversible causes of dementia?

A 
alcohol dependance
hypothyroidism
vitamin B12 deficiency
neurosyphilis
depression
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16
Q

wha are some irreversible causes of dementia?

A 
alzheimers disease
vascular dementia
frontotemporal dementia
Lewy body dementia
parkinsons
huntington disease
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17
Q

what is APP?

A

amyloid precursor protein

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18
Q

how do beta amyloid plaques form?

A

amyloid precursor protein is broken up by beta secretes and gamma secretes (rather than alpha and gamma) which produces amyloid beta. this is not soluble and so bind together outside neurones, forming plaques.

19
Q

how does alzheimers impair brain function?

A

amyloid beta plaques get between neurones, impairing brain fucntion

20
Q

what happens if amyloid plaques deposit in blood vessels around the brain?

A

it causes amyloid angiopathy which weakens the vessels and increases risk of haemorrhage

21
Q

what are tau proteins?

A

proteins that holds microtubules in the cytoksleteon together

22
Q

how do beta amyloid plaques affect tau proteins?

A 
the plaques (outside the cell) initiate kinase activity which adds phosphate groups to the tau protein. this makes the protein stop supporting the microtubule, gets tangles with other tau proteins = forms neurofibrillary tangles within the cell
neurones with tangles and non-functioning microtubules cant function and undergo apoptosis
23
Q

why is there low acetylcholine levels in the nucleus basalts and hippocampus in alzheimers disease?

A

due to impaired activity of choline acetyltransferase

24
Q

why are patients with the e4 allele for the APOE gene more likely to have alziemers than those who dont have this allele?

A

apolipoprotein e helps breakdown beta amyloid but the e4 allele is a lot less effective than other alleles so the patient is more likely to develop amyloid plaques

25
Q

which mutations are associated with…
- sporadic alzheimers
- familial alzheimers
?

A

sporadic - APOE- e4

familial - PSEN-1 and PSEN-2 and trisomy 21

26
Q

what are PSEN-1 and PSEN-2?

A

presenelin-1 and presenilin 2

protein subunits of gamma secretase

27
Q

what happens when you have mutations in PSEN-1 and PSEN-2?

A

we get a change in the location of where gamma secretase chops up APP, producing different length amyloid molecules. these seem to be more likely to clump up and form plaques

28
Q

on which chromosome is APP gene located?

A

21

29
Q

what are pick bodies?

A

tangles of tau proteins

30
Q

what are some examples of tauopathys?

A

pick disease and alzheimers disease

31
Q

whats the difference between pick disease and alzheimers disease (in relation to them both being tauopathys)

A

pick disease only has 3R isoforms

alzheimers has both 3R and 4R isoforms

32
Q

what forms Lewy bodies?

A

misfiled alpha synuclein

33
Q

which areas do lewy bodies mostly affect?

A

cortex and substantia nigra

34
Q

in what diseases are Lewy bodies seen in?

A

Lewy body dementia
parkinson disease
(may also see some Lewy bodies in the tangles seen in alzheimers)

35
Q

what is Parkinson disease?

A

a slowly progressive genetic disorder that is characterised by the loss of dopaminergic neurones in the substantial nigra (basal ganglia)

36
Q

why does the loss of dopaminergic neurones in the substantia nigra cause parkinsonian symptoms?

A

as usualy there is a balance of dopamine (promotes movement) and acetylcholine (inhibits movement)
here loss of dopamine causes less moevement, difficulties in speech/swallowing as well as cognitive symptoms like dementia

37
Q

what is Huntington disease?

A

autosomal dominant neurodegenerative disorder

38
Q

what causes Huntington disease?

A

a mutation in the HD gene on chromosome 4. this gene encodes for a protein called Huntingtin. this gene contains CAG trinucleotide repeat which encodes for glutamine amino acid/huntington.

39
Q

where do we see neuronal cell death in Huntington disease?

A

in the caudate and putamen of the basal ganglia

40
Q

outline the neurotransmitter levels in Huntington disease?

A

basal ganglia has decreased GABA and ACh as well as increased dopamine
also excessive activation of NMDA receptors which leads to glutamate excitotoxicity = damages neurones

41
Q

what are the main symptoms of alzheimers?

A 
confusion 
disorientatin
difficulty making decsions
hallucinations
probes with speech
memory loss
personality changes
42
Q

what are the main symptoms of vascular dementia?

A 
memory issues
balance problems slowness of thought
difficulty understanding and concentrating
changes to mood and behavuiur
disorientation and confusion
43
Q

what are the main symptoms of Lewy body dementia?

A 
mental ability issues
hallucinations
onfusion
slow movement
parkinsons symptoms
fainting and unsteadiness
disturbed sleep
difficulty swallowing
44
Q

what are the main symptoms of frontotemporal dementia?

A

personality changes
language and speech problems
becoming distracted
memory loss

REVISION EXTRAS (7 decks)

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