Final Exam Flashcards
What is a tumor?
A mass of cells whose growth is uncontrolled and serves no useful function
What are the two forms of tumors?
Malignant (cancerous)
Benign
How do tumors damage brain tissue?
Compression
Infiltration
Malignant can compress and infiltrate
Benign tend to only compress
Where does a primary brain tumor take place?
Starts in the CNS
Where does a secondary brain tumor take place?
Metastasize to brain
What does metastasize mean?
Spreads to other sites
Where do most brain tumor metastasize from?
Lung and breast cancer
What is Grade 1 CNS Tumor?
Low proliferative potential
Possibility of cure after surgical resection
What is a Grade 4 CNS tumor?
Histologically malignant
Prone to necrosis
Rapid preoperative and postoperative disease progression and fatal outcomes
What are three types of brain tumors?
Gliomas
Astrocytoma
Meningioma
What is a gliomas?
Most common primary brain tumor type
Tumor of the glial cells (astrocyte, oligodendrocytes, etc.)
What is a astrocytoma?
Tumor of the astrocytes
What is Grade 4 astrocytoma called? How long is survival rate?
Glioblastoma Multiforme
Approx. 2 years
What is a meningioma?
Tumor of the meninges, usually benign and slow growing
What are the three types of treatments for brain tumors?
Surgical resection
Radiation
Chemotherapy
What is a seizure?
A period of sudden, excessive activity of cerebral neurons
What is epilepsy?
Chronic diagnosis of recurrent seizures
What is partial/focal type of seizure?
Hits one area of the brain
What is simple partial seizure?
No major change to consciousness
What is a complex partial seizure?
Causes a loss of consciousness
What is a generalized type seizure?
Hits multiple areas of the brain
What are the three types of generalized type seizures ?
Tonic-clonic (aka Grand-mal)
Absence (aka Petit-mal)
Atonic
What is a tonic-clonic (Grand-max) seizure?
Most common form of seizure
Includes convulsions (violent uncontrollable muscle movement)
What the 4 stages of a tonic-clonic seizure?
Aura stage
Tonic stage
Clonic stage
Postical stage
What happens during a tonic stage?
The body is stiff and back is arched
What happens during a clonic stage?
Jerking movements or twitching
What makes up an ictal stage?
Tonic stage + Clonic stage
What is an absence (petit-mal stage)? How long does it last?
Sudden lapse in consciousness
15 seconds
What symptoms occur during a absence seizure?
Staring blankly into space
Eyelid fluttering
Lip smacking
Involuntary hand movement
What is an atonic seizure?
Drop seizure
What is a common symptom of a atonic seizure?
Sudden loss of muscle control
Slump or fall forward
How is atonic seizure different from cataplexy in narcolepsy?
Atonic seizures have a loss in consciousness
What are some challenges people with seizures face?
Damage to the hippocampus
Falling
Drowning
Car accidents
Pregnancy complications
What is prion disease?
Occurs when protein found throughout the body begins to fold into an abnormal three dimensional shape
What are transmissible spongiform encephalopathies?
A type of Prion disease
What are the two types of transmissible spongiform encephalopathies?
Creutzfeldt-Jakob disease (aka Mad Cow disease)
Kuru Disease
What were the symptoms of mad cow disease?
Mental deterioration
Dementia
What were the symptoms of kuru disease
Laughing
Total loss of muscle control
Inability to eat
What is Parkinson’s disease?
A deficiency of automatic, habitual motor responses
What percent of Parkinson’s disease is sporadic?
95%
What are symptoms of Parkinson’s disease?
Dystonia (rigidity)
Bradykinesia (slow movements)
Falling
Shuffling gait
Face masking (lack of facial expression)
Tremors
How do you test dystonia (rigidity)?
Cog wheel test
How do you test for tremors?
Rolling a pill in between fingers
What is Huntington’s disease?
Inherited disease resulting in degeneration of thee basal ganglia
What are symptoms of Huntington’s disease?
Chorea (involuntary jerking movements)
Dystonia (rigidity)
Slurred speech and swallowing difficulties
What is amyotrophic lateral sclerosis?
A disorder that attacks spinal cord and cranial nerve motor neuron
Brain and muscle connection loss
How much of amyotrophic lateral sclerosis is sporadic?
90%
What are symptoms of amyotrophic lateral sclerosis?
Progressive weakness and muscular atrophy
Eye movement spared
Respiratory failure which leads to death
What is multiple sclerosis?
An autoimmune demyelinating disease
What are sclerotic plaques?
Hard patches of debris left behind when the immune system attacks myelin sheaths
What are some risk factors for multiple sclerosis?
Higher in females
Living far the equator
Black or white race
Smoking
What are some symptoms of multiple sclerosis?
Fatigue
Vision problems
Bladder/bowel dysfunction
Spasms
Slowed processing speeds
How do supplement companies exploit slowed processing speed in multiple sclerosis?
Symptoms seem to drop when they take supplements but there periods of time during Progressive Relapsing Multiple Sclerosis where there is less symptoms, but then the symptoms come back. So patients think the supplements are working but they may not
What is meningitis?
Inflammation of the meningies caused by viruses or bacteria
What are common symptoms of meningitis?
Stiff neck
Headache
AMS
What is brudzinski’s sign?
Flexion of the hips and knees in response to neck flexion
What is kerning’s sign?
Resistance to extension of the leg while the hip is flexed
What percent of people that have dementia have Alzheimer’s?
60-80%
What is Alzheimer’s?
Most common form of dementia
An abnormal shrinkage of the brain that affects every brain function
What is vascular dementia?
Stroke or vascular accidents cause brain damage and tissue loss
What is lacunar infarcts?
Mini strokes that cause microvascular changes and over time prompt dementia symptoms
What impairments do vascular dementia test look for?
Semantic memory
Visuo-spatial/Perceptual skills
Slow processing speed
With cuing/recognition can recall information
What impairments do Alzheimer’s Dementia test look for?
Episodic memory
Language
Cuing/recognition does not help
What is akathisia?
Subjective unpleasant feeling of restlessness
What is tardive dyskinesia?
Symptoms irreversible but Vitamin E can prevent further deterioration
What percent of resting oxygen does the brain use?
20%
What percent of glucose metabolism does the brain use?
60%
What percent of energy goes to maintaining neurons and glial cells?
25%
What percent of energy goes to electrical signaling across the brain’s circuit?
75%
What is the neural tube?
Serves as the embryonic brain and spinal cord
Divides to form basic brain regions
What is apoptosis?
Planned and purposeful neuronal cell death
What is necrosis?
Unplanned and uncontrolled cell death
Is schizophrenia correlated with increased or decreased synapse?
Decreased
Is autism correlated with increased or decreased synapse?
Increased
What is the function of the frontal lobe?
Executive functioning (emotional regulation, planning and reasoning )
Personality
What is the function of prefrontal cortex?
Planning
Storage
What is the function of the ventromedial PFC?
Empathy
Guilt
What is the function of the parietal lobe?
Integrating sensory information (touch, temperature, pressure, and pain
What is the function of the temporal lobe?
Processing sensory information which is important for hearing,, recognizing language, and forming memories
What is the function of the occipital lobe?
Visual processing
Where is the primary auditory cortex found?
Temporal lobe
Where is the primary visual cortex found?
Occipital lobe
What is function of the basal ganglia?
Controls motor control
What happens when there is suppression of motor function in the basal ganglia?
There is a decrease in ability to carry out purposeful movement
What does ADME stand for when thinking of pharm-kinetics?
Absorption
Distribution
Metabolism
Excretion
How many liters of blood is pumped every minute?
5L
What is the fastest administration method?
Intravenous (IV)
Where is a intravenous administration method located? How long does it take?
Into a vien
30-60 seconds
Where is a intraperitonal administration method located?
Tube going into the stomach
Where is a intramuscular administration method located?
Directly into a muscle
Where is a subcutaneous administration method located?
Into fat
Where is a intracerebral administration method located?
Into the brain
Where is a intracerebroventricular administration method located?
Into the CSF
What is a sublingual administration?
Under the tongue
Where is a intrarectal administration method located?
Into the rectum
How does the inhalation administration work?
Through the lungs
How does the insufflation administration work?
The mucus membrane of the nasal passages
What is the equation for Therapeutic Index?
ED50 + TD50
Is a Therapeutic Index most dangerous when it is high or low?
Lower
What is the ideal Therapeutic Index?
Greater than 10
What is a therapeutic index?
A quantitative measurement of the relative safety of a drug
What is a agonist?
A molecule that stimulate/activiates a response when it binds to a receptor
Increases postsynaptic effects
What is a antagonist?
A molecule that blocks or inhibits a response when it binds to a receptor
Lowers postsynaptic effects
What is the mesolimbic dopamine pathway?
Route between VTA, Nucleus accumbent, and limbic system (hippocampus and amygdala)
What does the mesolimbic dopamine pathway play a role in?
Pleasure and Reward
Substance Use
What is the mesocortical dopamine pathway?
Route between VTA/Nucleus accumbent and PFC
What is the mesocortical dopamine pathway?
Route between VTA/Nucleus accumbent and PFC
What is the corticotropin-releasing hormone (CRH)?
Hormone released when experiencing stress
How does stress impact the brain?
Strengthens the amygdala
Weakens the hippocampus and prefrontal cortex
How many drinks meets the CDC drinking guidelines for moderate drinking in women and men?
Women = 1 drink per day
Men = 2 drinks per day
How many drinks meets the CDC drinking guidelines for heavy drinking in women and men?
Women = 8 or more drinks per week
Men = 15 or more per week
How many drinks meets the CDC drinking guidelines for moderate drinking in women and men?
Women = 4 or more within 2-3 hours
Men = 5 or more within 2-3 hours
What are some risk factors for stimulants?
Reduced seizure threshold
Higher blood pressure, heat rate, and hypertension which leads to higher risk of stroke and MI
Poor appetite
Mood sings
What is the endocannabinoid system?
Vast network of chemical signals and cellular receipts that are densely packed throughout our brains and bodies
What is phytocannabinoid?
A biologically active compound found in cannabis
How is cannabis absorbed?
Inhalation
Oral
How is cannabis distributed?
Distributes rapidly to well-vascularized organs
Builds up in adipose tissue
How does cannabis metabolize?
Through the liver
Cross the placenta; released in breast milk
Urine, feces, and sweat
What is glucose?
Primary source fuel for the brain
What happens to mesolimbic activation with increased likes and retweets on scoaif media addiction?
Increases
Increased use of social media is associated with what disorders?
SUD
ADHD
Depression
Anxiety
What is ventromedial prefrontal cortex?
Interface between emotional responses and control of complex behaviors
What happens to the VMPFC with courage?
Increase in activation
What happens to the VMPC in impulsive/emotional murders?
Decrease in activation
What happens when romantic partners see photos of their partners?
Increase in caudate nucleus (processes visual information and controls movement)
Increase in ventral segmental area (mediates reward system)
What hormones are released during love and brain?
Increase in cortisol and adrenalin
How long does each sleep cycle last
90 minutes
What happens when daylight savings occurs?
Increase in heart attacks
Increase in mood disturbances and suicide
What are the effects of sleep deprivation in rats ?
Damage to portions of the thalamus (information relay station)
What happens during sleep deprivation?
Decrease in glycogen stores and increase in adenosine = sleepiness
What is melatonin?
Produced by the pineal gland in response to evening/darkness about 2 hours before normal sleep
Where does melatonin come from?
Serotonin is converted into melatonin
How much exogenous melatonin should be taken and how early before bedtime?
1-2 mg
30 minutes - 1 hour
What percent of adults experience insomnia?
30%
What is primary insomnia?
Difficulty falling asleep after going to bed or after awakening during the night
What is secondary insomnia?
Inability to sleep due to another mental or physical condition
What can chronic use of sleep-promoting drugs cause?
Rebound insomnia
What is orexin-related neurological d/o?
85% orexin-producing neurons
REM-related symptoms occur inappropriately
What are sleep attacks?
Overwhelming urge to sleep
Last 2-5 minutes
What is cataplexy?
Sudden muscle weakness/paralysis
What is sleep paralysis?
Inability to move before onset of sleep or waking
What is REM sleep behavior d/o?
Lack muscle paralysis during REM –> act out dreams
Comorbid w/ narcolepsy
What is sleep apnea?
Difficulty sleeping and breathing at the same time
Wake up gasping for air and decreased slow wave activity
What does the Broca’s area involve?
Motor
Frontal Lobe
Broken Words
What does the Wernicke’s area involve?
Sensory
Temporal Lobe
Word Salad
What is learning?
Acquisition of new information
What are the 3 stages of learning?
Stage 1: Sensory Information
Stage 2: Short-Term Memory
Stage 3: Long Term Memory
What happens in Stage 1: Sensory Information?
Information is processed through our senses
What happens in Stage 2: Short Term Memory?
Meaningful and salient information is processed
What happens in Stage 3: Long Term Memory
Short memories are converted in to long term memory (made solid)
What is observation learning/social learning theory?
Process of learning by watching the behaviors of models
How does observational learning take place?
Occurs via operant conditioning and vicarious conditioning
What is vicarious conditioning?
Learning more by watching other people learn
What is an example of vicarious conditioning?
Watching your sister put on lipstick but seeing your mom yell at your sister for putting it on so you learn not to put it on
What is Middle Cerebral Artery (MCA) Stroke?
Stroke in the largest brain arteries
90% of strokes
What are some symptoms of a MCA Stroke?
Contralateral weakness and sensory loss in upper extremities
Loss of visual of field
What kind of symptoms are associated with a Left MCA Stroke?
Speech deficits (Broca’s and Wernicke’s)
What kind of symptoms are associated with a Right MCA Stroke?
Neglect and Poor Motivation
What is Anterior Cerebral Artery (ACA) Stroke?
Stroke in arteries that supply the frontal, parietal, corpus callous and bottom of the cerebrum
What type of ACA Stroke is more common?
Left sided ACA stroke
What are symptoms of ACA Stroke?
Contralateral motor and sensory loss in lower extremities
Poor gait and coordination
Slowed initiation
Flat affect
Urinary Incontinence
What is a key form of treatment for post-stroke depression?
Early psychopharmacological treatment
What does BE FAST stand for when it comes to strokes?
Balance
Eyes
Face
Arms
Speech
Time
What is a Tissue Plasminogen (tPA)?
Helps restore blood flow to brain regions affected by stroke
What happens if someone is not administered tPA?
Hemorrhagic effects take place
More melanin in you skins leads to what?
Harder to synthesize Vitamin D
What happens with magnesium deficiency?
W/ stress it can increase agitation, anxiety, and sleeplessness
Increase restless leg syndrome
What is anorexia associated with?
Loss of gray and white matter in the brain
Enlarged ventricle
Inhibited facial expression
What is alpha diversity?
How many species are present and how diverse are they
What is beta diversity?
Comparing two different samples of species in two different people
What is a possible explanation for an increase in chronic inflammatory disorders in high income countries?
Reduced exposure to the microbial environment
What is happening when there is loss of consciousness in SAH?
The percussive blood pressure increases intracranial pressure and therefore cerebral perfusion pressure
What are the symptoms of a Hunt and Hess Grade 1 stroke?
Asymptomatic
Minimal headache
What are the symptoms of a Hunt and Hess Grade 5 stroke?
Deep coma (most important)
Decerebrate rigidity
Moribund appearance
What is hemiplegia?
Paralysis affecting one side of the body
What is hemiparesis?
A lesser degree of weakness than hemiplegia
What is neglect?
Failure to attend to, respond to, and or report stimulation that is introduced contralateral to the lesion
What is neglect?
Failure to attend to, respond to, and or report stimulation that is introduced contralateral to the lesion
What is agnosia?
Acquired inability to associate a perceived unimodal stimulus with meaning
A disorder of recognition (can not name the thing)
What is anosagnosia?
Denial of a deficit
What is prosopagnosia?
Impaired ability to recognize faces
What isa closed brain injury?
Non-penetrating injury to the brain with no break in the skull
How may a closed brain injury result?
Rapid forward and backward movement of the brain and skull
Where does a countercoup brain injury take place?
Opposite side of impact
At what rate do TBIs occur in males and females and at what age is it the highest?
Males = 400,000 (15-24 years old)
Females = 80,000 (15-24 years old)
What is a diffuse axonal injury?
Axons in the white matter have been twisted, sheered, and ripped
What is the recovery process of CTE?
ASK JAHNIA TO PUT ON BOARD
How is a mild TBI classified?
Duration of unconsciousness = < 30 minutes
Glasgow Coma Scale Score = 13 - 15
Post Traumatic Amnesia = <24 hours
How is a moderate TBI classified?
Unconsciousness = 30 minutes - 24 hours
Glasgow = 9-12
Amnesia = 1-7 days
How is severe TBI classified?
Unconsciousness = >24 hours
Glasgow = 3-8
Amnesia = >7 days
What three categories does the Glasgow scale measure?
Eye opening
Motor response
Verbal response
What are some non-injury risk factors. that influence TBI outcomes?
Pre-injury psychiatric status (anxiety/depression)
Conduct issues/incarceration
Age at injury
Level of education
Marital staus (perceived social support)
