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Year 2 > Brain and Behaviour > Flashcards

Brain and Behaviour Flashcards

1
Q

What is the corpus striatum made up of?

A

Caudate nucleus and putamen

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2
Q

What do the putamen and globus palidus make up?

A

Lentiform nucleus

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3
Q

What type of neurons are medium spiny neurons?

A

Inhibitory GABAergic neurons

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4
Q

What do D1 receptors do?

A

They increase CAMP, leading to increased phosphorylation and increased sensitivity of striatum to glutamate

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5
Q

In PD what part of the brain loses dopaminergic neurons?

A

Substantia Nigra pars compacta

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6
Q

What medication primarily treats dyskinesia symptoms?

A

Amantadine

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7
Q

What is abnormally repeated in Huntington’s?

A

CAG codon - glutamate

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8
Q

What chromosome do you find mutated Huntington gene?

A

Chromosome 4

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9
Q

What is lost in Huntington’s?

A

Loss of GABAergic neurons in striatum = less inhibition = shift towards direct pathway

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10
Q

Where can you find the aggregated Huntintin?

A

They are intranuclear inclusions

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11
Q

What mutations are associated with PD?

A

SNCA mutation, codes for alpha synuclien
LRRK2
GBA, codes for B glucocerebrosidase

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12
Q

What enzyme converts L-tyrosine to L-dopa?

A

Tyrosine hydroxylase

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13
Q

What enzyme converts L-dopa into dopamine

A

L-aromatic amino acid decarboxylase

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14
Q

What are ropinirole, rotigotine, apomorphine, bromocriptine examples of?

A

Dopamine agonists

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15
Q

What are rasagiline, selegilline and safinamide examples of?

A

MAO-b inhibitors

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16
Q

How do anticholinergic compounds work for PD?

A

Counteract imbalance - dopamine loss leads to hyperactivity of cholinergic cells

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17
Q

What is tetrabenazine?

A

A vesicular amine transporter inhibitor - causes depletion of neuroactive peptides such as dopamine in nerve terminal (for HD)

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18
Q

Name some antidopaminergic drugs

A

haloperidol, olanzapine

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19
Q

What do lesions of premotor cortex lead to?

A

Motor apraxia - difficulty performing complex tasks (but normal reflexes)

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20
Q

What might abnormal saccades be a sign of?

A

Damage to frontal eye fields

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21
Q

Where does decussation happen in corticospinal tract? And if there is injury below decussation what will you get?

A

C1-C5
Motor deficit on the same side

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22
Q

Where does rubrospinal tract arise? and what does it do?

A

Red nucleus in brain stem - it excites flexor muscles and inhibits extensor muscles

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23
Q

What does tectospinal tract do and where does it arise?

A

It originates in the superior colliculus and it coordinates voluntary head and eye movements

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24
Q

Which posturing indicates lesion above red nuclues?

A

Decorticate

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25
Q

If the cerebellum is injured on one side where will symptoms be and why?

A

On the same side as lesion as anterior spinocereballar tract decussates twice and posterior is direct = net effect zero

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26
Q

What is anterior lobe syndrome?

A

Damage to spinocerebellum - leads to ataxic gait, hypotonia, depressed or pendular reflexes. Can also be seen in alcoholics due to malnutrition

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27
Q

What are symptoms of flocculonodular syndrome? (vestibulocerebellar injury)

A

Little control of axial muscles, ataxic gait, tendency to fall to side of lesion, nystagmus
Often occurs due to medulloblastoma tumour in 4th ventricle that compresses nodulus

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28
Q

Name the capsaicin/vanilloid receptor

A

TRPV1 channel

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29
Q

What does ASIC channel stand for?

A

Acid sensing ion channel

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30
Q

What nociceptor detects menthol?

A

TRPM8

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31
Q

What can cause congenital insensitivity to pain?

A

Loss of Nav1.7

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32
Q

What causes inherited erythomelalgia?

A

Mutation of SCN9A gene that encodes Na1.7

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33
Q

How do C fibres activate lamina 1?

A

Via excitatory interneurons in lamina II

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34
Q

What causes congenital insensitivity to pain anhidrosis?

A

mutation to TRKA gene

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35
Q

What region modulates descending pain?

A

PAG. (Which can then activate locus coreulus which contains noradrenergic neurons - further modulation)

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36
Q

How can serotonin modulate pain?

A

serotonin and noradrenlin active interneurons which can stimulate release endogenous opioids which open Cl- channels and block Ca2+ channels on sensory neurons inhibiting firing
AND
serotonin can activate 5HT1a receptors on first order neurones to inhibit neurotransmission

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37
Q

How do you treat morphine overdose?

A

NA-loxone (opiate antagonist)

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38
Q

How does paracetamol work?

A

It stops prostaglandin synthesis by reducing active form of COX1 and COX2. It also inhibits reuptake of endogenous cannabinoids

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39
Q

What is celecoxib an example of and why is it not normally used?

A

A selective COX2 inhibitor and bc of the cardiovascular effects

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40
Q

How does diclofenac work?

A

It inhibits prostaglandin formation but it preferentially inhibits COX2

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41
Q

What do carbamazepine and sodium valproate act on?

A

Sodium channels - prevent sustained firing of action potentials

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42
Q

What does pregablin work on?

A

Inhibits Alpha2 delta1 subunit of calcium channels. Causes decreased release of neurotransmitters

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43
Q

What type of drug is baclofen?

A

muscle relaxant - GABAb receptor agonist

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44
Q

How does tramadol work?

A

Acts on mu receptors and interacts with monoaminergic systems - inhibits 5ht and NA uptake

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45
Q

What drug is duloexetine?

A

SNRI

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46
Q

Clonazepam is used for trigeminal neuralgia, what kind of drug is it?

A

a benzodiazepine - amplifies GABAa receptor

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47
Q

What is the MAO of local anaesthetics?

A

Blockade of sodium channels

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48
Q

What is the name of fluid found in ear which is rich in potassium?

A

Endolymph

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49
Q

What is Meniere’s disease?

A

disorder of inner ear - vertigo, tinnitus etc. results from excessive endolymph accumulation

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50
Q

What is Hallpike maneouvre?

A

Lower head to the floor, if patient gets dizzy the ear pointing the floor is affected

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51
Q

What is the pathopysiology of cell death in ischaemic stroke?

A

Less ATP- failure of Na/K pumps, resulting in depolarisation. Leads to influx of calcium ions and glutamate release. Elevated calcium = cell death

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52
Q

What kind of stroke is likely to be pure motor OR pure sensory Or cause ataxic hemiparesis

A

lacunar stroke

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53
Q

What is alteplase

A

Dissolves clot in a stroke by cleaving plasminogen

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54
Q

What is secondary prevention of stroke?

A

clopidogrel 75mg daily or aspirin and a statin such as atorvastatin

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55
Q

Which region of brain do you find prominent loss of cells in epilepsy?

A

CA2 and CA3 hippocampal area

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56
Q

What cells are lost in epilepsy?

A

Inhibitory chandelier cells

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57
Q

What cells can cause abnormal neuronal excitability in epilepsy?

A

Glial cell deficiency

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58
Q

What epilepsy drugs induce drug metabolism in the liver and are also not used in absence seizures?

A

phenytoin and carbamazepine

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59
Q

What epilepsy drug is zero order?

A

Phenytoin

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60
Q

What is an anti-epileptic drug that can be used in all types of seizures?

A

Sodium valproate

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61
Q

What GABA receptor does Topiramate act on?

A

Gaba A topirAmate

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62
Q

What epilepsy drugs target calcium channels?

A

Ethosuximide and Gabapentin

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63
Q

What are the difference between benzodiazepines (clonazepam) and barbiturates (phenobarbitone, striripentol)?

A

Both work on GABAa but Ben increases channel opening frequency and Barb makes them open for longer.
Ben wants it more frequently, Barb wants it for longer

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64
Q

What do you give in status elipticus?

A

Lorazepam or diazepam

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65
Q

Difference between primary headaches and secondary headaches?

A

Primary - absence of physical signs eg migraine,
Secondary - presence of signs eg meningitis, sinusitis

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66
Q

What centre is activated in migraine?

A

Trigeminal vascular system

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67
Q

What neurotransmitter acts on blood vessels in dura causing them to dilate in migraine?

A

Serotonin

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68
Q

What area leads to central sensitisation which mediates allodynia in mirgaine?

A

Spinal trigeminal nucelus caudilis

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69
Q

What part of the brain is responsible for the premonitory changes in migraine?

A

Hypothalamus

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70
Q

What is an important inflammatory neuropeptide that gets released in migraine?

A

CGRP

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71
Q

What metabolite increases in urine immediately after a migraine?

A

5HIAA metabolites

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72
Q

What is the mechanim of action of triptans?

A

5HT 1D/1B agonists - vasoconstrictive

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73
Q

What type of drugs are rimegepant, ubrogepant, atogenpant and how do they work?

A

Gepants - small molecule CGRP antagonists. They prevent vasodilation

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74
Q

What functional deficits are normally present in a middle cerebral artery stroke on the non dominant hemisphere?

A

Neglect syndrome - left becomes more active so results in attention and and eye movements towards the right. Might bump into things on left

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75
Q

Functional deficits of anterior cerebral strokes?

A

contralateral sensorimotor loss below waist. Personality defects if frontal lobe

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76
Q

Functional deficits of posterior cerebral strokes?

A

Contralateral homonymous hemianopia, reading writing deficits

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77
Q

What cranial nerve is normally affected by epidural hematoma?

A

CN III. Because of increase in pressure - herniation of temporal lobe (uncal herniation), gets compressed at tentorial edge (eyelid drooping, pupil dilation)

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78
Q

What type of extra-axial bleed is a venous bleed?

A

Subdural haematoma

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79
Q

What type of bleed often presents with a severe thunderclap headache?

A

Subarachnoid

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80
Q

What might an Alzeimher’s post mortem look like?

A

1) Extreme shrinkage of hippocampus,
2) extreme shrinkage of cerebral cortex
3) severely enlarged ventricle

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81
Q

What are the senile plaques in AZD made up of?

A

deposits of amyloid-beta protein

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82
Q

What are neurofibrillary tangles in AZD made up of?

A

tau protein

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83
Q

What might you see in a FGD-PET scan for AZD?

A

Hypometabolism in temporal, parietal, frontal regions and posterior cingulate cortex

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84
Q

What cleaves amyloid precursor protein in AZD?

A

beta secretase and gamma secretase to produce A-beta peptides
in healthy brain it is alpha secretase and gamma secretase to P3 peptide

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85
Q

What does hyperphosporylation of Tau cause?

A

Causes it to detach from microtubules which makes them become unstable and depolymerise

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86
Q

Which APOE mutations cause what?

A

APOE epsilon 2 is rare and can protect, epsilon 3 is neutral and epsilon 4 increases risk of AD

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87
Q

What mutations can lead to early onset AZD?

A

Presenlin-1 (chromosome 14)
Presenlin-2 (chromosome 1)
Amyloid precursor protein (chromosome 21)

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88
Q

Name some acetylocholinesterase inhibitors

A

Donepezil, Galantamine and Rivastigmine
Don Galanting to the River.

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89
Q

Name a NDMA receptor antagonist for AZD

A

Memantine (think people doing MDMA making memes)

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90
Q

What is the Default Mode network and how does it function in patients with depression?

A

It is a network of brain regions active when brain is at wakeful rest. Depressed patients have increased functional connectivity between DMN and fronto-parietal networks

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91
Q

What areas of brain are hyperactive in ruminating thoughts?

A

Hippocampus, amygdala, subgenual cinugulate medial prefrontal cortex

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92
Q

What areas of the brain are hypoactive in ruminating thoughts?

A

ventrolateral prefrontal cortex, dorsolateral prefrontal cortex

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93
Q

How does ketamine work as an antidepressant?

A

An NMDA glutamate receptor antagonist, enhances transmission at glutamergic synapse

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94
Q

What is brexanalone?

A

Used in post partum depression. Progesterone related compound - post modulator of GABAa

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95
Q

What can monoamine oxidase inhibitors interact with?

A

tyramine containing food

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96
Q

Name some selective serotonin reuptake inhibitors

A

Citalopram, fluoxetine, paroxetine

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97
Q

What type of drug is moclobemide?

A

Monoamine oxidase inhibitor (selective for MAOa)
Social anxiety and depressive illness

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98
Q

What class of drug is Duloxetine?

A

SNRi

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99
Q

What kind of drug is Agomelatine?

A

It is a a new drug for depression. It is an agonist at MT1 and MT2 receptors

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100
Q

How is bipolar managed?

A

With lithium

101
Q

What part of the brain evaluates the degree of pleasure or pain in an outcome and then suggests appropriate action?

A

Anterior cingulate cortex

102
Q

What is the role of the insula in memory?

A

Makes the decision whether an event is worth remembering or not. Insula = internalise feelings or not?

103
Q

What are the low and high road through which fear reaches the amygdala?

A

Low - fast - fight or flight. Thalamus&raquo_space;> amydala
High - slow. Thalamus&raquo_space; sensory cortex&raquo_space; amygdala.

104
Q

What is Urbach Weithe disease?

A

Rare disease that causes collagen to build up in amydala - no fear

105
Q

What parasite can exploit the amygdala and leads to increased risky behaviour?

A

Toxoplasma gondii

106
Q

What are panda eyes / orbital ecchymoisis signs of?

A

Basal skull fracture

107
Q

In severe TBI what seizure prophylaxis would you use?

A

Phenytoin / levetiracetam

108
Q

What parts of the hypothalamus promotes arousal and sleep?

A

Arousal - tuberomammillary nucleus TMN and suprachiasmatic nucleus
Sleep - ventrolateral preoptic nucleus

109
Q

How can consciousness be assessed through auditory stimulation?

A

positive P300 around 300ms after auditory change
MMN (mismatch negativity) around 100-250ms after an auditory change

110
Q

What is often damaged in locked in syndrome?

A

Ventral pons - interruption of corticospinal and corticobulbar tracts

111
Q

Zolpidem can be used for brain injury. How does it work?

A

It is indirect GABAa receptor agonist. Restores normal inhibition in the GPi, allows an increase of thalamic excitatory influence on prefrontal cortex to initiate movement

112
Q

What an be up-regulated in drug abuse?

A

dynorphin receptors

113
Q

In cocaine abuse what receptors are there less of?

A

D2 receptors

114
Q

What is upregulated in all kinds of addiction?

A

Delta- Fos-B

115
Q

What inhibits aldehyde hydrogenase in addiction?

A

Disulfiram

116
Q

What antidepressant drug can be given for nicotine addiction?

A

Bupropion (a monoamine reuptake inhibitor)

117
Q

What opioid agonists can be used for opiate addiction?

A

Methadone - opioid agonist. Buprenorphine - partial agonist

118
Q

What does naltrexone do?

A

It is an opioid antagonist. Blocks high that addicts might have, used after detoxification

119
Q

What do clonidine and lofexidine do for addiction?

A

They are alpha-2-adrenoreceptor agonists - they alleviate the autonomic hyperactivity during withdrawal

120
Q

What will a schizophrenia MRI show?

A

Larger ventricles, and a reduction in brain volume

121
Q

What part of the brain is hyperactive in SCH?

A

Mesolimbic dopaminergic pathway (think hyper-limbs. someone thrashes their limbs around)

122
Q

What area is hypoactive in SCH?

A

mesocortical dopaminergic pathway and nigrostriatal pathway

123
Q

What pathway can be blocked in SCH and can lead to a rise in prolactin and sexual dysfunction?

A

Blockade of tuberoinfundibular pathway

124
Q

How can you test for frontal cortical dysfunction testing?

A

Wisconsin card sorting

125
Q

What do all SCH drugs do?

A

Antagonists at D2 receptors

126
Q

What are first line for SCH treatment

A

atypical antipsychotics - risperidone, olanzapine, clozapine, aripiprole etc
(dopamine D2 receptor antagonists, and also signific antagonistic activity at 5HT2a receptors

127
Q

What antipsychotic can cause neutropenia or agranulocytosis?

A

Clozapine

128
Q

How does pregablin treat insomnia?

A

It binds to alpha 2 delta 2 subunit of voltage gated calcium channels

129
Q

What are orexins?

A

They are peptides produced in the hypothalamus as either orexin A or orexin B. They regulate arousal, appetite and wakefulness

130
Q

How does suvorexant work?

A

It is a orexin antagonist to treat insomnia

131
Q

What do the Z drugs bind to?

A

alpha 1 subunit of GABAa

132
Q

Name some benzodiazepines?

A

Clonazepam, alprozolam, lorazepam

133
Q

What kind of drugs are used for stage fright like symptoms?

A

B adrenoreceptor antagonists (propanolol)

134
Q

How do benzodiazepines work?

A

They are positive allosteric modulators - they enhance GABAa receptor activity. Means increased chloride influx which means firing less likely

135
Q

How is benzo overdose managed?

A

Flumazenil - antagonist at BZD sites

136
Q

What receptors are redistributed to potentiate or weaken memories

A

AMPA receptors

137
Q

What can be examined in lumbar puncture of patient with MS?

A

oligoclonal bands of IgG. OCB bands determine presence of neurofilaments

138
Q

What do MS drugs do?

A

They all suppress the immune system. Alemtuzumab and cladribine are first line for induction and they work on CD52. For acute relapse = high dose corticosteroid

139
Q

Romberg’s test what does it mean if problem when eyes are open and closed vs just closed?

A

open and closed = cerebellar deficit
closed = propioceptive deficit

140
Q

What is the Uthoff phenomenon?

A

It is temp vision loss linked to physical activity (due to temp) that is associated with optic neuritis

141
Q

What type of EEG will you get when awake?

A

Low amplitude waves as the asynchronous firing cancels out

142
Q

What free radical scavenger is released during sleep?

A

Melatonin from pineal gland - removes free radicals - antioxidant

143
Q

What part of brain decides when we need sleep?

A

Hypothaolamus decides and then it commands to pons to turn off reticular formation and trigger sleep

144
Q

What hormones inhibits and increases sleep?

A

Grehlin inhibits
Leptin and adenosine induce sleep

145
Q

Where are cholinergic cells located?

A

Pedunculopontine nucleus

146
Q

What are the online nuclei active in REM sleep?

A

Cholinergic nuclei. (think ACEtylcholine responsible for ACE dreams)

147
Q

why are people with sleep apnoea at a higher risk of stroke?

A

surge in sympathetic activity that happens after anoxia, increases BP and can rupture a cebreal blood vessel

148
Q

How do TCAs promote sleep?

A

They exert blockade of histamine H1 receptors

149
Q

What nerves leave through superior orbital fissure?

A

Occulomotor CN3
Trochlear CN4
Abducens CN6
and opthalmic branch of trigeminal CNV1

150
Q

What nerve goes through the foramen rotendum?

A

CNV2 = maxillary nerve

151
Q

What nerve goes through foramen ovale?

A

CNV3 = mandibular

152
Q

What foramen does the facial nerve leave through?

A

Stylomastoid foramen

153
Q

What nerve travels within the carotid sheath?

A

Vagus

154
Q

What does a lesion to occulomotor nerve cause?

A

Down and out position, pupil dilates due to loss of parasympathetic innervation and also drooping of the eyelid

155
Q

what does injury to trochlear nerve cause?

A

Rarely injured alone but double vision when looking down

156
Q

What would injury to abducens present with?

A

Medial deviation and dilopia (double vision)

157
Q

What is the path taken by CSF?

A

Lateral ventricles > Interventricular foramina > third ventricle > cerebral aqueduct > fourth ventricle

158
Q

Of delusions, hallucinations, disorganised speech, disorganised behaviour and negative symptoms how many must you have to have shizophrenia?

A

At least two of them and one of them much be hallucinations, delusions or disorganised speech

159
Q

What are the advantages of atypical anti-psychotics?

A

They better address cognitive symptoms and they have less extrapyramidal side effects

160
Q

What are the main disadvantages of atypical side effects?

A

metabolic side effects - weight gain, dyslipideamia, T2D
also anticholinergic side effects eg dry mouth, constipation

161
Q

What must be checked before starting someone on lithium?

A

Renal and thyroid function

162
Q

Where do noradrenergic originate?

A

Locus coeruleus

163
Q

What do the TCA drugs end with? (two things)

A

-pramines and -triptylines
eg clomipramine and amitriptyline

164
Q

In DBS for depression what part of the brain would you target?

A

Subcallosal cingulate white matter - area 25

165
Q

What is MAO of moclobemide?

A

selective and reversible MAOA inhibitor

166
Q
A
167
Q

Why can diclofenac lead to increased bleeding risk?

A

Bc it inhibits thromboxane

168
Q

What tract is involved in occulomotor reflex, saccacidic eye movements and vestibular occular reflexes?

A

Medial vestibulospinal tract (head and eye coorindation, upright posture of head and neck)

169
Q

What part of the brain directs the correct emotional or motor response in light of knowledge from past experience?

A

Medial prefrontal cortex (might be absent in people with autism)

170
Q

What part of the brain works with the medial prefrontal cortex to play a role in reward mediated behaviours?

A

Orbitofrontal cortex
(remember it as it is near the eyes and the eyes see the reward)

171
Q

Where does the globus pallidus external project to?

A

subthalamic nucleus

172
Q

What pathway becomes dominant in PD?

A

Indirect pathway
(decreased inhibition of GPi which increases inhibition on the thalamus)

173
Q

What does athetosis suggest a lesion to?

A

Striatum
(athetosis is slow writing movements)

174
Q

What does ballismus suggest a lesion to?

A

Subthalamic nucleus
(violent involuntary flinging movements_

175
Q

What are the main cells lost in Huntington’s?

A

Loss of medium size spiny neurons

176
Q

What is the most common site of infarct in posterior circulation?

A

PICA - posterior inferior cerebellar artery

177
Q

Damage to what part of the cerebellum can lead to vertigo, nystagmus and ataxic gait?

A

Vestibulocerebellum

178
Q

Damage to what part of the cerebellum can lead to intention tremors, dysmetria and dysdiadochokinesis?

A

Neocerebellum
(as it is involved in motor planning)

179
Q

Damage to what part of the cerebellum can lead to ataxic gait, hypotonia and pendular reflexes?

A

spinocerebellum
(called anterior lobe syndrome common in alcoholics)

180
Q

What does medial vestibulospinal tract and lateral vestibulospinal tract do?

A

medial - balance of head on body
lateral - balance of body on ground

181
Q

What tumour commonly causes flocculonodular syndrome?

A

Medulloblastoma in 4th ventricle

182
Q

What are the semi circular canals full of?

A

endolymph

183
Q

What movements does utricle detect?

A

horizontal

184
Q

What movements does the saccule detect?

A

vertical movement

185
Q

What is the central main connection for the occulomotor, trochlear and abducens nerves?

A

Medial longitudinal fasiculus

186
Q

When is the COWS mneumonic correct?

A

for the nystagmus (referring to the fast component) but not for initial eye movement which is CSWO

187
Q

What nerve does the caloric test test?

A

cranial nerve 8 - vestibulocochlear

188
Q

If you still have the slow component of caloric reflex in both eyes intact what does this mean vs just in one eye?

A

Both eyes means the brainstem is intact
One eye only means there is an MLF lesion

189
Q

What fibres carry the first sharp, stinging pain

A

A delta (myelinated)

190
Q
A
191
Q

Which spinothalamic tract is more associated with pain and temp?

A

Lateral
whereas anterior is mainly crude touch

192
Q

Where does lateral STT project to to cause emotional aspect of pain?

A

anterior cingulate cortex and rostral insular cortex

193
Q

Whereabouts is peri-aqueductal grey?

A

Midbrain (around cerebral acqueduct)

194
Q

what is activated by PAG for descending pain modulation?

A

Locus coeruleus (contains noradrenergic neurons)

195
Q

What are activated by serotonin and noradrenaline in descending pain modulation and what do they release?

A

Lamina II inhibitory interneurons
They release GABA and enkephalins to block noiceptor input

196
Q

What channels do opioid receptors have an effect on to inhibit firing of sensory neuron?

A

Thye open Cl- ion channel and block Ca2+ channek

197
Q

Why does meptazinol result in less resp depression?

A

It is a partial mu receptor agonist

198
Q

Why is pethidine and morphone avoided in patients with kidney failure?

A

Bc its metabolites norpethidine M6G and can accumulate

199
Q

Why can glial cell abnormalities play a role in epilepsy?

A

Bc glial cells clear glutamate through transporters like EAAT1 and EAAT2

200
Q

How does levetiracetam work for seizures?

A

Binds to SV2A which inhibits presynaptic calcium channels modulating neurotransmittter release

201
Q

What blood vessels come off at a right angle to middle cerebral artery?

A

Striate arteries

202
Q

What is blood supply to corpus collosum?

A

Anterior cerebral artery (lesions = split brain)

203
Q

Where is the blood in a subdural hematoma?

A

Between dura mater and arachnoid mater

204
Q

What brain bleed can lead to xanthochromia and often resembles a STEMI on ECG?

A

subarachnoid hematoma

205
Q

Which type of headache is only headache more common in men?

A

cluster headache

206
Q

How do ditans work for migraine?

A

They are 5HT1F agonists (they dont cause vasoconstriction so can be used in people with cardiac issues)

207
Q

What drugs are non specific to migraines but can be used as prophylactic treatment?

A

anti epileptics and beta blockers

208
Q

What is the minimum and maximum GCS score?

A

Minimum = 3
Max = 15

209
Q

what is considered moderate TBI score?

A

9-12

210
Q

When would you perfom CT head?

A

If GCS is less than 13 at initial assessment or less than 15 at two hours post

211
Q

What is normal intracranial pressure?

A

5-15mmHg

212
Q
A
213
Q

How are TBI patients sedated?

A

Propofol and benzos

214
Q

What does systematic desensitization refer to?

A

The idea of replacing one response (anxiety) with another (relaxation)

215
Q

What does operant conditioning use?

A

Rewards and punishments

216
Q

Difference between pos and neg punishment?

A

pos - application of unpleasant stimulus
neg - removal of a pleasant stimulus

217
Q

What is Bandura’s theory and how can we apply it?

A

theory people can change by watching other people cope - befriending interventions

218
Q

What does Schacter-Singer Two Factor theory suggest?

A

That physiological arousal is interpreted in context of the experience to produce the emotion

219
Q

When does Moro reflex disappear?

A

Between 3-6 months of age

220
Q

Where does amygdala mainly project to in fear?

A

prefrontal cortex for behavioural response
hypothalamus and autonomic nuclei for autonomic fear responses

221
Q

How is rhabdomyolysis blocked?

A

By dantrolene - muscle relaxant that lessens excitation-contraction coupling in muscle cells.

222
Q

Where are CB1 and CB2 receptors located?

A

CB1 in CNS, CB2 - peripheral organs

223
Q

What is acamprosate?

A

Helps reduce alcohol cravings, modulator of glutamatergic transmission

224
Q

Difference between methadone and naltrexone?

A

Methadone is a mu opioid agonist - suppress withdrawal and naltrexone is an antagonist- used after detoxification

225
Q

what cerebellar nuclei involved in motor execution and which in motor planning?

A

fastigial and interposed = motor execution
dentate = motor planning

226
Q

What can mutations in MAPT cause?

A

frontotemporal dementia

227
Q

What results in aggregation of Tau?

A

Its hyperphosphorylation

228
Q

What synapses are particularly affected by neurotoxic alpha beta oligomers?

A

cholinergic synapses

229
Q

What can interact with alpha beta peptide and promotoe amyloid fibril formation?

A

acetylcholinesterase

230
Q

How can memantine work for AZD?

A

It is an NMDA receptor antagonist, blocks the ion channel and decreases glutamate mediated neurotoxicity

231
Q

Which neurons increase their activity during REM sleep to same level as alert waking?

A

Cholinergic neurons

232
Q

What do anterior and posterior hypothalamic lesions cause?

A

anterior = insomnia
posteior = hypersomnia
think towards front of lecture theatre everyone is awake but towards the back they are sleepy

233
Q

What is nucleus reticularis paragigantocellularis?

A

Involved in descending pathyway of pain, projects to nucleus raphe magnus

234
Q

What do the neurons of the tuberomamillary system release?

A

Histamine. They are tonically active during wakefulness

235
Q

What is the brain’s sleep promoting region?

A

Ventrolateral preoptic nucleus

236
Q

What stage of sleep is vital for maintenance and repair?

A

slow wave sleep

237
Q

What stage of sleep does somnambulism occur during?

A

slow wave sleep

238
Q

What neurons are involved in sleep?

A

GABA and galanin

239
Q

Which waves are present during normal wakefulness and then which when youre awake but relaxed?

A

normal wakefulness= beta waves
awake and relaxed = alpha waves (slower)

240
Q

Which receptors do buspirone, ipsapirone act on? (anxiety treatment)

A

5HT 1A (partial agonists)

241
Q

What subunits of GABA receptors are to do with what effect?

A

alpha1 = hypnotic
alpha2= anxiolytic

242
Q

Damage to which part of the brain causes locked in syndrome?

A

Ventral pons - causes interruption to corticospinal and corticobulbar tract

243
Q

When is vegetative state deemed permanent?

A

12 months after traumatic injurt
3 months after non traumatic injurt

244
Q

What drugs are used in treatment resistance schizoprhenia?

A

Clozapine - only drug that seems to work when resistant

245
Q

How does baclofen work for pain?

A

GabaB receptors agonist

246
Q

How does ketamine work for pain?

A

It is an NMDA glutamate receptor antagonist

247
Q

What toxic metabolite can build up if using opioids and have renal failure

A

M6G metabolite

248
Q

first line for trigeminal neuralgia?

A

carbamazepine

Year 2 (10 decks)

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