Brain Diseases 2

Question 1

Schizophrenia
synptoms - + and -

associated with which other disorders/ problems?

Answer 1

+ = delusions, hallucinations,disordered thought/speech
- = flat affect, alogia, anhedonia(inability to feel pleasure), asociality(lack of motivation to be social), avolition
(often in association with depression, substance abuse and suicide)
life expectancy often reduced by 10-12yrs

Question 2

SCZ

pathology

Answer 2

high levels of dopamine in the mesolimbic pathway

Question 3

SCZ

incidence

Answer 3

0.6% of population, worldwide

can start at any age, but peak onset = early 20s

Question 4

SCZ

causes

Answer 4

Genetics - 50% c rate with MZ twins
Environment - 50% c rate in MZ
Developmental - infection in utero, poor diet during pregnancy, asphyxia during birth
Social factors - urban environment, stressful relationships
Drug abuse - cannabis, amphetamine, cocaine - cause and effect?
Dopamine hypothesis - excessive D2R stimulation
reduced NMDAR function

Question 5

SCZ

treatment

Answer 5

antipsychotics (typical and atypical)- more effective in treating positive symptoms
intense psychotherapy, social support
recovery and improvement in symptoms in&raquo_space;50%

Question 6

Depression

symptoms

Answer 6

lowered mood, anhedonia, avolition, altered appetite, hypo/hyperkinesia, guilt, lack of concentration, thoughts of death
3-7% risk of suicide

Question 7

Depression

pathology

Answer 7

reduced hippocampal volume
vascular lesions
reduced BDNF

Question 8

Depression

incidence

Answer 8

3% japan
18% USA ( average = 10% )
Women twice as likely as men
Massive cost to society

Question 9

Depression

causes

Answer 9

genetic - 5HT transporter abnormalities
monoamine hypothesis - not all antidepressant drugs work on monoaminergic system) - depletion doesn’t consistently cause depression - drug effects refractory
Psychological - self/others/future
social - poverty/ stress/ abuse

Question 10

Depression

treatment

Answer 10

light therapy, sleep deprivation
psychotherapy
tricyclic antidepressants
SSRIs eg. Prozan and Paxil
Exercise
ECT

Question 11

Stroke -define

characteristics?

Answer 11

a neurological deficit of cerebrovascular cause that persists beyond 24hrs or is interrupted by death within 24hrs
(distinguished from a transient ischaematic attack, which is a syndrome of stroke-like symptoms that resolve within 24hrs)
-brain relatively intolerant to ischaemia/lack of 02 and glucose
-Due to high energy demands and minimal energy reserves brain function ceases within 60-90 secs of ischaematic events
Irreversible damage if event >3hrs duration
-Neurological deficit related to the site and extent of damage

Question 12

Types of strokes

Answer 12

1) Ischaematic - embolus= wandering clot, thrombus = ‘locally-formed’ clot, systemic hypoperfusion eg. heart attacks
2) Haermorrhaegic strokes: entry of blood into CNS via rupture of a blood vessel/ sinus or aneurysm

Question 13

Physical arrangements of meninges

Answer 13

Closest to CNS to furthest:
Pia mater, arachnoid, Dura mater

• between pia and arachnoid = subarachnoid space
• lines connecting pia and arachnoid = trabeculae
• between arachnoid and dura = subdural space

Question 14

Classification of haematomas affecting the brain:

Answer 14

epidural - traumatic damage to a meningeal artery or dural venous sinus (eg.blow to head)
subdural - caused by a rapid movement of head causing tearing of cerebral vein as it enters dural venous sinus
subarachnoid - damage to cerebral artery or vein and subsequent bleeding into subarachnoid space
intracerebral - caused by damage of a blood vessel within the brain

Question 15

Stroke

incidence

Answer 15

10% deaths worldwide
2nd leading cause of death
95% occur >45yrs

Question 16

Stroke

causes

Answer 16

• Ischaematic concade - ATP production reduced= ion pumps fail = increase glutamate = NMDA receptors activated = Ca++enters neuron = ROS/free radicals produced = cell death (inflammatory response may cause further damage
• Pressure

Question 17

Stroke

risk factors

Answer 17

high BP
high cholesterol
Diet
physical inactivity
drug abuse

Question 18

Stroke

treatments

Answer 18

a) preventative - anticogulants, diet, carotia angioplasty
b) acute ischaemic - thrombolysis, angioplasty, thromboectamy
c) acute haemorrhagic - surgery
d) chronic post stroke - control of hypertension, aspirin, physical and occupational therapy

Question 19

Epilepsy define
2 types?
prevelance?

Answer 19

seizure = abnormal, transient highly synchronous brain activity (epilepsy = repeated seizures)
2 types:
1) partial/ focal
2) generalised
prevelance: 0.5-1%, 5% experience non febrile seizure

Question 20

Examples of epilepsy:

Answer 20

-childhood absence epilepsy = 4-12yrs
absence seizures, 3Hz spike wave discharge, resolves during puberty, mutations in low threshold voltage-gated Ca++ channels
-Temporal lobe epilepsy = late childhood and adolescence
most common type in adults, epileptogenic focus in hippocampus or amygdala or parahippocampal gyrus, complex partial seizures, may develop into secondary generalised tonic-clonic/ grand mal seizures

Question 21

Epilepsy causes

Answer 21

-2/3 = idiopathic nature, reflex seizures, genetic mutation in Na+ channels, tumours, drugs, disease, infection, disorders, trauma, pathological synaptic plasticity (producing an imbalance in excitation and inhibition in nervous system)

Question 22

Epilepsy treatment

Answer 22

• acute = recovery position, reassurance, benzodiazepines

- chronic = pharmacological, surgical, electrical, avoidance of triggers

Question 23

Alzheimers Disease

symptoms

Answer 23

short-term memory loss, progressive apathy, confusion, mood swings, LT memory loss, death within 7yrs of diagnosis

Question 24

Alzheimers pathology

Answer 24

profound loss of neurons
plaques
neurofibrilloy tangles

Question 25

Alzheimers incidence

Answer 25

1.5-2%, worldwide cost = 160 billion per yr

Question 26

Alzheimers causes

Answer 26

age, 10% over 65, 50% >85
genetics (for early onset)
trauma
high bp/ hyperchlosteremia
environment?

Question 27

Alzheimers treatment

risk factors?

Answer 27

symptoms - acetylcholinesterase inhibitors, NMDA recpeptor antagonists
risk - MSAIDs and caffeine, intellectual stimulation needed, diet and exercise