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Semester 3 (M+M) > General Questions > Flashcards

General Questions Flashcards

1
Q

Name 5 risk factors for schizophrenia

A

Genetics (50% identical twin chance)
Substance abuse (inc risk if start younger/ heavier)
Poor development/ low socioeconomic status
Low birth weight/ low O2 at birth
Stress

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2
Q

Name 3 positive symptoms of schizophrenia

A

Delusions (Untrue belief)- Often grandeur or paranoia
Hallucinations (False perceptions)- Mainly auditory
Thought echo/ thought broadcasting

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3
Q

Name 5 negative symptoms of schizophrenia

A

Avolition (lack of motivation- stop wash/ eat etc)
Anhedonia (inability to experience pleasure)
Flat emotion
Alogia (poverty of speech)
Asociality (lack of desire for relationships)

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4
Q

What are the three components of the GCS?

A

Motor (1-6)
Verbal (1-5)
Eyes (1-4)
Total 3 is worst, 15 is best (<8 is severe)

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5
Q

Which gender has a higher stroke incidence?

A

25% higher in men but more women due to older F population

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6
Q

Name 10 RF’s for a stroke

A

Age, raised BP, smoking, obesity, diabetes, afrocarribean, stress, alcohol, previous stroke/ TIA, cocaine, family history, high cholesterol

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7
Q

What are the diagnostic criteria for GAD (generalised anxiety disorder)?

A

Excessive worry for more days than not for >6months

Three or more of: (Restlessness, fatigue, irritability, sleep disturbance, low concentration)

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8
Q

What are some possible caused of GAD (generalised anxiety disorder)?

A

Brain area overactivity- Amygdala
NT imbalance (serotonin/ adrenaline)
Genetics
Traumatic experience/ long term illness/ substance abuse

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9
Q

What are some of the symptoms of depression in MDD or the depression phase of bipolar? (10)

A

Sad, hopeless, lack of energy, concentration difficulty, loss of interest, guilt, despair, sleep difficulty, decreased appetite, pessimism, self doubt

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10
Q

What are some of the symptoms of the mania phase of bipolar disorder? (9)

A

Elation, quick talking, full of energy, self important, new ideas + plans, spend more money, more promiscuous, drink more, increased libido

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11
Q

What are the two types of bipolar disorder?

A

I (raging)- Severe mainia (>1wk) affecting ability to function combined with severe depression
II (swinging)- Hypomania with severe depression with possible level mood periods

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12
Q

What is cyclothymia?

A

(BIPOLAR) Hypomania episodes with mild depressive episodes (mild form of bipolar)

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13
Q

What is rapid cycling (bipolar)?

A

4 or more mania/ hypomania/ depressive episodes within 12 months (can occur with any type of bipolar)

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14
Q

What are some of the risk factors for a foetus developing spina bifida?

A

Family history

Mother: Low folic acid, taking valproate/ carbamazepine, has diabetes or obesity

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15
Q

What % of babies are breech at a) 28wks b) 37wks c) how is this corrected?

A

a) 20% b) 3%
External cephalic version offered (50% success)
Then caesarean offered at 39wks (normal time)

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16
Q

NICE guidelines suggest long term management following a stroke should include what ‘blood thinner’ medication?

A

Anti-platelet (e.g. clopidogrel)

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17
Q

Generalised anxiety disorder is linked to which over-active brain region?

A

Amygdala

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18
Q

What area’s control a) understanding/ comprehension of speech b)motor formation of speech?

A

a) Wernickes - understanding of speech

b) Brocha’s - motor speech induction

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19
Q

The sneezing reflex is triggered by sensory stimulation of which cranial nerve?

A

Trigeminal

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20
Q

How is folic acid (Vit B9) activated?

A

Via enzymatic activation (Dyhydrofolate reductase- takes place in the liver)
Biologically active form is tetrahydrofolate

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21
Q

Folate deficiency is accelerated by consumption of what?

A

Alcohol

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22
Q

Problems with folate deficiency are often linked with what other deficiency?

A

Vitamin B12 (can present with megaloblastic anaemia)

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23
Q

If a P presents in adulthood with a congenital abnormality, they complain of headaches but were asymptomatic in childhood. They are most likely to be diagnosed with?

A

Chiari T1 malformation

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24
Q

The DNFB1 mutation is associated with what?

A

Mutation in the GJB2 gene

Most common form of congenital deafness

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25
Q

Define pharmacokinetics

A

(What the body does to the drug)

The branch of pharmacology concerned with the movement of drugs within the body

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26
Q

Define pharmacodynamics

A

(What the drug does to the body)

The branch of pharmacology concerned with the effects of drugs and the mechanism of their action

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27
Q

What are the fraser guidelines?

A

Guidelines set out saying a doctor could provide treatment (contraception) for an under 16 providing they met conditions (such as understanding

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28
Q

What are dermatomes?

A

Form from the lateral wall of each somite in the embryo. They are a region of skin supplied by nerves from a single spinal root

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29
Q

Intramuscular injections in the gluteal region should only be given in what quadrant?

A

Upper lateral

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30
Q

Describe the path of the needle from skin to CSF in a lumbar puncture

A

Skin > ligamentum flavum (1st give) > dura mater (2nd give) > now in subarachnoid space

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31
Q

Where is a lumbar puncture performed?

A

Lumbar cistern region (from conus medularis at L1/2 to around S2). Oftern performed at L4/L5. Cistern is a swelling of the subarachnoid space

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32
Q

What is the prevalence, most common diagnosis age/ ethnicity and M/F ratio in MS?

A

1 in 1200
M1:3F
White (Near the equator lowest risk)
Presents most commonly between 20 and 40

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33
Q

What are the most commonly seen plaque sites in MS?

A

Optic nerves, brain stem, corpus callosum, periventricular region

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34
Q

What genetic area is linked to MS?

A

MHC complex on chromosome 6

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35
Q

What are the most common MS symptoms?

A

Limb weakness/ numbness and tingling
Blurred/ double vision/ no colour/ pain (Optic neuritis)
Ataxic gait/ nystagmus/ (tremor- later on)

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36
Q

How would you diagnose MS?

A

Any two lesions in two or more places
(dissemination in time and space)
MRI to confirm
Slow evoked potentials/ oligoclonal banding

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37
Q

What are oligoclonal bands?

A

Bands of immunoglobulins in CSF (indicative of MS)

Could be monoclonal (just one band) can show other disease or be normal

38
Q

What are the three types of MS?

A 
RRMS (90%, average 1 relapse per year) 
Secondary progressive (late stage, gradually worsening diability)
Primary progressive (no relapses/ remittance)
39
Q

What is a teratogen?

A

Any agent which can affect the development of an embryo or foetus

40
Q

What is the most common diagnostic age for schizophrenia?

A

15-35
M often early 20’s
F often late 20’s

41
Q

On what conditions can Schizophrenia be diagnosed?

A

1st rank sympt for >1mth (Hallucination/ delusion/ though echo/ broadcasting)
2nd rank symp for >1mth

42
Q

The theraputic effect of blocking D2 receptors comes from blocking which brain area?

A

Limbic striatum

43
Q

Which two dopaminergic pathways are involved in schizophrenia and how?

A

Nigrostriatal (SNpc to striatum)- RAISED DA

Mesocortical (VTA in midbrain to dorsolateral prefrontal cortex)- LOW DA

44
Q

In schizophrenia, dopamine dysregulation is secondary to what?

A

NMDA receptor hypofunction

Glutamate

45
Q

Action of antipyschotics on which receptor causes side effects of dry mouth and tachycardia?

A

M1

46
Q

Action of antipyschotics on which receptor causes side effects of orthostatic hypotension?

A

Alpha adrenoreceptor

47
Q

Action of antipyschotics on which receptor causes side effects of sedation?

A

H1

48
Q

What is an autoreceptor?

A

Receptor stimulated upon release of neurotransmitter from the same cell

49
Q

What type of drug could be given to treat alzheimers?

A

Acetylcholinesterase inhibitors

50
Q

What are the central effects of cannabinoids?

A

Impaired short term memory/ motor coordination
Analgesia
Increased appetite

51
Q

What are the peripheral effects of cannabinoids?

A

Tachycardia, vasodilation, bronchodilation

52
Q

What is akathisia?

A

Can’t keep still

53
Q

What are the symptoms of hyperprolactinemia?

A

Raised hCG, breast enlargement, diminished libido, amenorrhea, galactorrhea and acne

54
Q

What is the pathophysiology of tonsillitis causing otitis media?

A

Enlarged adenoids block eustachian tube so block mucus removal from middle ear

55
Q

Name the risk factors for otitis media (5)

A

Nursery or day care centre, exposure to smoking, formula not breast milk, using dummy, downs/cleft palate

56
Q

Who is most commonly affected by otitis media?

A

75% are under age 10. Most common 15mths-6years

57
Q

What treatment is given for otitis media?

A

Often viral so clears up alone, only AB’s if >4days sympt or very severe or younger than 3 months

58
Q

What are the symptoms of otitis media?

A

Earache (pulling ear if young)
Hearing loss
Fever
Irritability/ lack of feeding

59
Q

What is glue ear?

What is the treatment?

A

Otitis media with effusion- 80% incidence before age 10
Fluid prevents ossicles from moving freely (hearing loss)
No treatment for 3months then consider grommits or adenoidectomy

60
Q

What is tonsillitis?

What is the most common cause?

A

Inflammation of MALT palatine tonsils
Most commonly viral cause (adenovirus, rhinovirus)
85% spontaneous recovery in 1 week

61
Q

What are the symptoms of tonsillitis?

A

Sore throat, headache, fever, cough, fatigue, swollen LN’s in neck, voice change
Signs of bacterial: High fever, white spots on tonsils, swollen LN’s

62
Q

What are the criteria for a tonsillectomy?

How is it done?

A

5 or more episodes in 1yr or >1yr disabling symptoms

Use diathermy or cold ablation

63
Q

Where are the adenoids?

What happens to them as you grow up?

A

Back of nasal cavity (can block eustachian tube- cause of otitis media)
They atrophy by teenage years

64
Q

What is SPECT?

A

Single positron emission computed tomography

Releases positrons which annihilate with electrons and release gamma waves (which the SPECT scanner detects)

65
Q

What is PET scanning?

A

Position emission tomography

Radiotracer (flurodeoxyglucose) releases gamma waves which are detected by the scanner

66
Q

What is the name for the infoldings of the cerebellum which increase its surface area?

A

Folia

Transversely orientated

67
Q

Name two proposed mechanisms of the placebo effect?

A

1) Reduce stress allowing normal bodily function

2) Cause brain to release its own analgesics

68
Q

What is the main blood supply to the anterior scalp?

A

Frontal and parietal branches of superficial temporal artery (a branch of the external carotid)

69
Q

What is the main blood supply to the posterior scalp?

A

Occipital artery (Branch of external carotid)

70
Q

What is the difference between rigidity and spasticity?

A

Rigidity is equal in both flexors and extensors, spasticity is not
Rigidity is the same through full range of movement, spasticity is velocity dependant

71
Q

What is prosopagnosia?

A

Can’t recognise faces

Type of agnosia

72
Q

How could spasticity be treated?

A

Baclofen

73
Q

How do cocaine and methamphetamines act on dopamine?

A

Block re-uptake channels

Increase synaptic conc

74
Q

What type of fibre carries all outputs from the cerebellum?

A

Purkinje

75
Q

What is leadpipe rigidity?

A

Increased muscle tone causes resistance through whole range of movement

76
Q

Define spasticity

A

Combination of partial paralysis with hypertonia

Caused by loss of motor neuron inhibition

77
Q

What makes up the lentiform nucleus?

A

Putamen and Globus Pallidus

78
Q

What is the most common triad of parkinsons symptoms?

A

Tremor, rigidity, bradykinesia

79
Q

Spasticity and rigidity are each seen in which Sem 3 diseases?

A

Spasticity: MS
Rigidity: Parkinsons

80
Q

What is the stria terminalis and what is it’s function?

A

Connects amygdala to ant hypothalamus and septal nuclei

81
Q

What is DVLA guidance following a stroke?

A

Can’t drive for 1 month

After can drive when medically fit

82
Q

What causes the lemon sign (often seen in pre24 week scans indicating spina bifida)?

A

Low CSF volume in ventricles

83
Q

What is the difference between emissary veins and normal veins?

A

Emissary have no valves

84
Q

Name three things that travel in the subarachnoid space ?

A

CSF, veins, arteries

85
Q

What is the confluence of sinuses?

A

Joining of superior sagital, straight sagital and occipital sinuses
Drains to transverse sinuses
Located deep to occipital protuberance

86
Q

What is a sagittal and coronal section?

A

Sagittal: (mid sagittal) slice through nose to back
Coronal: Ear to ear slice

87
Q

What is the adams apple?

A

Prominence on thyroid cartlidge in neck

88
Q

What is the epiglottis?

A

A flap of elastic cartlidge which when larynx is pulled up during swallowing it is pulled down to block food going into the larynx

89
Q

What is indicated by the babinski sign?

A

Upper motor neuron lesion

90
Q

What is the cause of rigidity?

A

Involuntary state of continuous muscle contraction due to loss of basal ganglia control

91
Q

What causes hyperprolactinaemia?

A

Decreased dopamine in the tuberoinfundibular pathway

Semester 3 (M+M) (16 decks)

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