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Clin Med I > Clin Med Exam 3 > Flashcards

Clin Med Exam 3 Flashcards

1
Q

Bipolar I

A

Manic episode + hypomanic or major depressive episode

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2
Q

Bipolar II

A

Hypomanic episode + major depressive episode

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3
Q

Membrane potential - net __ charge inside cell

A

Negative

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4
Q

Sodium concentration is greater where?

A

Outside cell

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5
Q

Potassium concentration is greater where?

A

Inside cell

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6
Q

Cell membrane is more permeable to which ion?

A

Potassium

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7
Q

How is resting membrane potential maintained?

A
  1. Na-K pump –> K in and Na out of cell

2. K passively leaving cell

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8
Q

In the presence of a chemical or electrical stimulus that reaches threshold…

A
  1. Membrane permeability to Na increases
  2. Na rushes into cell due to electrical and chemical gradient
  3. Depolarization of cell
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9
Q

ALS

A

Increased glutamate
Extremities affected first
Eye movement, sensation, B&B preserved

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10
Q

Huntington’s Disease

A

Autosomal dominant
Random involuntary movements, dysdiadochokinesia
Atrophy of basal ganglia

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11
Q

Multiple Sclerosis

A

Progressive demyelination (CNS)
Relapsing/ remitting
2 neurological lesions
Exercise helps function, avoid excess fatigue

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12
Q

Parkinson’s Disease

A

Disease of basal ganglia, increased dopamine produced
Characterized by tremor, rigidity, bradykinesia
Festinating gait, cogwheel
PT: big movements

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13
Q

Alzheimer’s disease

A

Slow decrease in memory, cognition, and behavior

Neurofibrillary tangles, amyloid plaques

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14
Q

Charcot Marie Tooth Disease

A

Hereditary PNS disease

Demyelination, often of peroneal nerve –> foot deformities

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15
Q

Guillan-Barre Syndrome

A

Progressive weakness due to infection that progresses from extremities up, may eventually lead to respiratory issues
Lesions in motor and sensory fibers –> demyelination

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16
Q

Post-polio strength

A

Declining muscle strength in previously affected muscles

Never exercise to point of fatigue

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17
Q

Myasthenia Gravis

A

Disease of neuromuscular transmission, decreased numbers of ACh receptors.
Generalized proximal weakness, especially eyes
Close monitoring for fatigue is important

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18
Q

Acute pain

A
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19
Q

Chronic pain

A

Pain that continues after noxious stimulus is gone

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20
Q

Allodynia

A

Interpretation of pain in response to a typically non-painful stimulus

21
Q

C fibers

A 
Most common nociceptors
Unmyelinated and small
Transmit dull, throbbing, aching pain
Slow onset, long lasting
Respond well to opioids
22
Q

A-Delta fibers

A

Myelinated and small
Transmit sharp, stabbing, pricking pain
Quick onset, shorter duration
Do not respond well to opioids

23
Q

Sensitization of nociceptors

A

Activation threshold is decreased –> hypersensitive

Achieved via chemical mediators e.g. histamines, bradykinins, prostaglandins

24
Q

Peripheral sensitization

A

Takes place at tissue site, nociceptors are hypopolarized

25
Q

Central sensitization

A

Brain interpretation center is hypopolarized

Includes both specific and wide-dynamic range
wide dynamic range respond to both noxious and non-nonxious stimuli

26
Q

A-beta fibesr

A

Larger fibers that activate SG (inhibit T cells and pain transmission)

27
Q

Where do a-delta fibers synapse?

A

More dorsal laminae (lower numbered laminae)

28
Q

Where do a-beta fibers synapse?

A

Deeper, higher numbered laminae

29
Q

What do T-Cells do?

A

Communicate with anterior horn cells –> muscle spasm –> compression of nerve endings –> physical stimulus –> pain –> spasm –> repeat

30
Q

SG is inhibited by…

A

A-delta and C fibers

31
Q

Ascending method of pain modification:

A

Gate theory

32
Q

Descending method of pain modification:

A

Endogenous opioids block pain modulators (e.g. substance P) –> blocks peripheral sensitization

33
Q

3 Mechanisms of seizure disorder drugs

A
  1. Increase activity of GABA (CNS inhibitory neurons)
  2. Decrease activity of CNS excitatory neurons (glutamate, aspartate)
  3. Stabilize opening and closing of neuronal Na and Ca channels, prolonging absolute refractory period
34
Q

Barbiturates

A

Increase effect of GABA

35
Q

Benzodiazepenes

A

Potentiate inhbitory effect of GABA

36
Q

Valproates

A

Limit sodium entry into excited neurons

37
Q

2nd generation drugs compared to 1st generation

A

2nd generation drugs have more favorable pharmacokinetics, but use same mechanisms and are not necessarily more effective

38
Q

Adrenocorticotropic Hormone

A

Used for infants who do not respond well to usual seizure medications

39
Q

Side effects of seizure meds

A

Sedation

Lack or change of coordination/ cognition

40
Q

Cerebral arteriography

A

Radiopaque contrast injected to map abnormalities in brain. Used for identification of ischemic and hemorrhagic stroke

41
Q

Carotid duplex scan

A

Ultrasound of carotid to assess obstructions. Adds blood flow velocity to imaging. Used for TIA

42
Q

Computed Tomography

A

Used for CNS diseases

43
Q

MRI

A

Better than CT for contrast between normal and abnormal tissue, better for congenital malformations
Used for CNS diseases

44
Q

PET

A

Used for CNS diseases (decreased activity with AD)..highly radioactive

45
Q

Myelography

A

X-ray image of subarachnoid space of spinal canal, used for SCI

46
Q

Electroencephalogram

A

Used for dx of seizures

47
Q

Electromyography

A

Used in muscle diseases and to differentiate between neurological conditions

48
Q

Nerve conduction tests

A

Used to identify and document severity of peripheral nerve damage

49
Q

Lumbar puncture

A

Used to diagnose infections

Clin Med I (5 decks)

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