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Brain and Behavior > Brain and Behavior, Week 4 > Flashcards

Brain and Behavior, Week 4 Flashcards

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The Brain flashcards
1
Q

Useful dermatomal landmarks:

A 
C5 = shoulder
T4 = nipple line
T10 = umbilicus
L1 = groin
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2
Q

Most common causes of locked-in syndrome:

A

Most common: Pontine stroke

2nd most common: osmotic demyelination syndrome

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3
Q

Hallmark signs of encephalitis:

A

HA, fever, mental status changes

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4
Q

Acute disseminated encephalomyelitis (ADEM):

A

Post-infectious auto-immune response to infection resulting in enchephalitis

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5
Q

Diagnostic criteria for pseudotumor cerebri:

A
  • Papilledema
  • Normal neuro exam except for CN abnormalities
  • Normal imaging
  • Normal CSF
  • High ICP
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6
Q

What event can provoke an absence seizure in susceptible individuals?

A

Hyperventilation

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7
Q

What is the EEG finding in a person having an absence seizure?

A

3 HZ spike and wave

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8
Q

Diagnostic criteria for MS:

A
  • At least 1 lesion in 2 of 4 spaces
  • New T2 or Gad enhancing lesion relative to baseline
  • Must meet criteria for both TIME and SPACE
  • 1st episode called “clinically isolated syndrome”
  • NOT a radiographic diagnosis
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9
Q

What’s the main advantage of disease modifying therapies for MS?

A
  • Reduction of relapse rates

- PROBABLY slows progression to disability

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10
Q

Some drugs for treating focal seizures:

A

Phenytoin, Carbamazepine

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11
Q

Side effects of phenytoin:

A

Ataxia, nystagmus, gingival hyperplasia, osteomalacia, long term cerebellar toxicity

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12
Q

What is ethosuxamine useful for?

A

Absence seizures

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13
Q

Depakote is highly protein bound. What’s the consequence of this with regard to its use with phenytoin?

A

They’re both protein bound, so using Depakote with phenytoin will decrease the fraction of phenytoin that’s protein bound, and therefore increase its serum concentration.

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14
Q

Major drug interaction with lamotrigine:

A

Valproic acid. Valproic acid can increase the concentration of lamotrigine by as much as 200%

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15
Q

Which anti-seizure drug in contraindicated in patients with a sulfa allergy?

A

Zonisamide

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16
Q

Upper boundary of the spinal cord:

A

Medial lemniscus

17
Q

Where do motor neurons cross from one side of the nervous system to the other?

A

Medulla

18
Q

What is the function of the medial lemniscus?

A
  • Area where somatosensory fibers traveling up the posterior columns decussate
  • Part of the posterior-column/medial lemniscus pathway
  • Made up of internal arcuate fibers, which are composed of nucleus gracilis and nucleus cuneatus axons
  • 1-ary axons synapse at nucleus gracilis/cuneatus, then 2-ary neurons decussate and travel contralaterally up to thalamus
19
Q

Upper motor neuron diseases:

A
  • MS
  • ALS
  • Cerebral palsy
20
Q

Lower motor neuron diseases:

A
  • Muscular dystrophy
  • Myasthenia gravis
  • ALS
  • Guillain Barre
  • Floppy baby
21
Q

MOA for phenytoin:

Uses:

A
  • Sodium channel antagonist

- Partial, general

22
Q

Indications for phenobarbitol:

CI:

A
  • Partial, general

- Liver or kidney dz, airway obstruction, porphyria

23
Q

MOA for carbamazepine:

Uses:

A
  • Sodium channel antagonist

- Partial, general

24
Q

MOA for Depakote:

A
  • Sodium/Ca channel antagonist, GABA agonist

- Partial, general, absence, infantile spasms, myoclonic/tonic

25
Q

MOA for benzodiazapenes:

Uses:

A
  • GABA potentiator, chloride channel enhancer

- Partial, general, myoclonic

26
Q

MOA for ethosuxamide:

Uses:

A
  • Ca channel antagonist

- Absence

27
Q

MOA for felbamate:

Uses:

A
  • GABA agonist, NMDA antagonist

- All seizures

28
Q

MOA for Lamictal:

Uses:

A
  • Sodium channel antagonist, glutamate inhibitor

- All seizures

29
Q

MOA for topiramate:

Uses:

A
  • Sodium channel antagonist, GABA agonist, NMDA antagonist

- Partial, general, absence, atonic, Lennox-Gastaut

30
Q

Indications for gabapentin:

CI:

A
  • Partial, general

- None (adjust for renal dosing)

31
Q

Indications for pregabalin:

CI:

A
  • Adjunctive

- None

32
Q

GABA-acting drugs:

A

Phenobarbitol, primidone, valproate, benzos, felbamate, tiagabine, gabapentin, pregabalin, topiramate, zonisamide, vigabatrin

33
Q

NMDA antagonists:

A

Felbamate, topiramate, pregabalin

34
Q

Sodium channel antagonists:

A

Phenytoin, phenobarbitol, primidone, valproate, carbamazepine, lamotrigine, topiramate, zonisamide

35
Q

Calcium channel antagonists:

A

Ethosuxamide, phenobarbitol, valproate, zonisamide

36
Q

Shy-Drager syndrome (Multi Systems Atrophy):

A
  • Severe autonomic dysfunction
  • Vocal cord problems: stridor
  • MRI shows cerebellar and pontine atrophy
  • Treat Sx (orthostasis, anhidrosis, incontinence, etc) and sleep (CPAP) problems
  • Levodopa for Parkinsonism

Brain and Behavior (3 decks)

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