Last Lecture Flashcards
1
Q
What is a mass of cells whose growth is uncontrolled and that serves no useful function?
A
Tumor
2
Q
What determines whether a tumor is malignant or benign?
A
Whether the tumor is encapsulated or not (Benign: encapsulated)
3
Q
How does malignant and benign tumors damage brain tissue?
A
Malignant: compress and infiltrate
Benign: compress
4
Q
How are primary and secondary brain tumors differ?
A
Primary: tumor starts in CNS
Secondary: tumor has metastasized to brain
5
Q
T/F: Benign tumor is more common in women, and malignant tumor is more common in men.
A
True
6
Q
T/F: Most common brain metastases are from lung and breast cancer.
A
True
7
Q
What is the most common primary brain tumor type?
A
Gliomas; (astrocytoma and meningioma are types of gliomas)
8
Q
What is Glioblastoma Multiforme?
A
- A grade 4 astrocytoma
- most aggressive tumor form
- can spread in months, prognosis is 2 year
- high incidents in white individuals
9
Q
What are some characteristics of meningioma?
A
- tumor of the meninges
- usually benign (encapsulated)
- slow growing (could take up to 10 years for symptoms to be noticed)
10
Q
What are the three main treatments of brain tumor?
A
- surgical resection (debulking)
- radiation
- chemotherapy
11
Q
What is a challenge with brain tumor radiation?
A
Damage to the hippocampus (but now they have hippocampus sparing, which prevents radiation from targeting hippocampus)
12
Q
What is a period of sudden, excessive activity of cerebral neurons?
A
Seizure
13
Q
What are the two types of partial/focal type seizure and how are they different?
A
- Simple partial: no major change in consciousness
- Complex partial: cause a loss of consciousness
14
Q
What are the three types of generalized type seizure?
A
- Tonic-Clonic (aka Grand mal; most severe)
- Absence (aka petit-mal)
- Atonic
15
Q
What happens in each of the stages of the Grand Mal seizure?
A
- Aura stage: hallucination, confusion, dizziness, etc
- Tonic stage: stiffening of muscle, incontinence, arched back
- Clonic stage: jerky movement, frothy saliva
- Postictal stage: exhausted, sleepy
16
Q
What are some symptoms of Petit Mal seizure and how long do they last?
A
- Sudden lapse in consciousness
- Staring blankly into space
- Eyelid fluttering
- Lip smacking
- Involuntary hand movements
- Last less than 15 seconds
17
Q
What are the characteristics of Atonic seizure?
A
- Aka “drop seizures”
- Sudden loss of muscle control, which results in collapse or fall
18
Q
How are cataplexy in narcolepsy and a fall in atonic seizure different?
A
Cataplexy: they are aware
Atonic: they are unaware (loss of consciousness)
19
Q
What are some problems that may come with seizure?
A
- 50% show damage to the hippocampus
- Falling
- Drowning
- Car accidents (unable to drive for 1 year post seizure event)
- Pregnancy complications
20
Q
What are some common mental/emotional health issues associated with seizure?
A
- Most common: ADHD, Anxiety, aggression
- 6-10% experience post-ictal psychosis
- Epilepsy increases risk of schizophrenia by 2.5x
21
Q
T/F: Neurodegenerative disorders continue to cause degeneration in your CNS.
A
True.
22
Q
What are the two common types of prion disease?
A
Creutzfeldt-Jakob disease and Kuru disease
23
Q
Prion disease
A
- When prion protein, found throughout the body, begins folding into an abnormal three-dimensional shape.
- Damaged prion protein destroys brain cells, leading to a rapid decline in thinking and reasoning.
- Also called Transmissible Spongiform Encephalopathies
24
Q
Creutzfeldt-Jakob disease
A
- Most common TSE
- Can be sporadic or familial
- Causes severe mental deterioration and dementia
- Prognosis: about 8 month
25
Kuru Disease
- From eating contaminated human brain tissue
- A part of traditional practice in Papa New Guinea
- Can have 10-50 year incubation period
- Leads to total loss of muscle control and dysphagia
26
Parkinson's disease
- Caused by the degeneration of dopamine-secreting neurons in the substantia nigra that send axon to the basal ganglia
- Causes a deficiency of automatic, habitual motor responses
- 95% cases are sporadic
27
What are some symptoms of Parkinson's disease?
- Dystonia (rigidity)
- Bradyskinesia & Slowed reaction times (resulting in falls)
- Shuffling gait
- Face Masking (lack of facial expression)
- Tremors
- Pill Rolling Tremor (75%)
28
What are some treatments for Parkinson's disease?
- L-Dopa (only works for a period of time; side effects of hallucinations and delusions)
- Deprenyl (slows Parkinson’s progression)
- lesioning of the pathway
- Deep Brain Stimulation (75% see relief of symptoms, but not good for those with cognitive/memory impairments)
29
Huntington's disease
- Inherited (chromosome 4 mutation)
- degeneration of the basal ganglia
- In DNA, CAG repeats more than normal
- Typical onset ages 30-50
- 10-15 year prognosis following symptom onset
30
What are the CAG counts in Huntington's disease?
- 27 to 35: no symptom but can pass on genetically
- 36 or more: HD
31
What are some symptoms of Huntington's disease?
- Chorea: involuntary jerking movements (almost like dancing movements)
- Dystonia
- Slurred speech and swallow difficulties
32
Amyotrophic Lateral Sclerosis (ALS)
- degenerative disorder that attacks spinal cord and cranial nerve motor neurons (supports brainstem), which results in brain and muscle connection loss
- Average onset age in late 50’s
- 10% inherited (mutation of chromosome 21 in inherited cases)
33
What are some symptoms of ALS?
- Progressive weakness and muscular atrophy
- eventual loss of speech, swallow, paralysis
- Eye movements are spared
- Death typically caused by respiratory failure (typically within 24 months)
34
Multiple Sclerosis
- an autoimmune demyelinating disease
- body attacks its own myelin sheaths and leave behind sclerotic plaques
- Onset in late 20’s to 30’s
- Damage occurs in white matter
35
What are some risk factors of MS?
- Females > Males
- Living far from the equator
- Black or white race
- Smoking
36
What are some symptoms of MS?
- Fatigue
- Vision problems
- Bladder/bowel dysfunction
- Spasms
- Slowed Processing Speeds
37
What are the four types of MS?
- Relapsing-Remitting
- Secondary Progressive
- Primary Progressive
- Progressive-Relapsing
38
What are some causes and etiology of meningitis?
- Virus (most common)
- Bacteria, fungus, parasite
- spread of middle-ear infection to the brain
- head injury
- embolus that has dislodged from bacterial infection in the heart
- *increased risk for IV drug users
39
What are some symptoms of meningitis?
- stiff neck
- headache
- altered mental status
- fever
-photophobia
40
What are the two meningitis tests?
- Brudzinski's sign: flexion of the hips and knees in response to neck flexion
- Kernig's sign: resistance to extension of leg while the hip is flexed
41
What is dementia and what are the five types?
- Umbrella term for loss of memory and other thinking abilities severe enough to interfere with daily life
- Alzheimer's
- Lewy body dementia
- Vascular dementia
- Frontotemporal dementia
- Mixed dementia
42
What is dementia and what are the five types?
- Umbrella term for loss of memory and other thinking abilities severe enough to interfere with daily life
- Alzheimer's
- Lewy body dementia
- Vascular dementia
- Frontotemporal dementia
- Mixed dementia
43
Alzheimer's
- accumulation of neuritic plaques (beta amyloid) and tau tangles
- exposure to toxins, TBI, infections may trigger
abnormal beta amyloid formation
- estrogen lowers risk of developing Alzheimer's
- memory loss is core symptom (ask: have you ever gotten lost in a familiar place?)
- onset later in life (70+)
44
Vascular dementia
- accumulation of small mini-strokes (lacunar infarcts)
- associated with brain damage due to ischemic injury and anoxia
- risk factors are same as stroke risk factors
- typical age of onset 65
45
What is the difference between mild cognitive impairment and dementia?
In mild cognitive impairment, ADL is generally okay.
In dementia, ADL becomes more difficult/impaired.
46
T/F: For Alzheimer's and vascular dementia, the patient is unaware that they have dementia.
False. In Alzheimer's, they are unaware they have dementia. In vascular dementia, they are aware that something is off about them.
47
How are impairments in Alzheimer's and vascular dementia similar and different?
Similar: Deficit in Executive/Attentional Functioning
Alzheimers: Impairments in Episodic Memory, Language, and Cuing/Recognition does not help
Vascular dementia: Impairments in Semantic Memory, Visuo-spatial/Perceptual Skills, Slowed processing speed, and With cuing/recognition paradigm can recall information
48
Dementia with Lewy body
Characterized by the abnormal build up of alpha-synuclein proteins into masses (lewy bodies)
49
What are the symptoms of Lewy body dementia?
- Visual hallucinations (one of the first symptoms)
- Falls & Dysautonomia (autonomic functions like blood pressure and body temp regulation is off)
- Movement issues
- Sleep problems (REM sleep disorder common)
- Fluctuating cognition
- Mood and behavior changes
50
T/F: with frontotemporal dementia, you can see the brain damages through imagining.
True
51
Frontotemporal dementia
Accumulation of Tau protein overwhelms the brain and causes tissue death
52
What are the three types of frontotemporal dementia?
- Behavioral Variant: most common, changes in personality and behaviors
- Primary Progressive Aphasia: communication progressively worsens
- Movement Disorders
53
Schizophrenia:
- 46% heritability rate
- 10x risk of African and Caribbean migrants
- Men > Women
- Mutation in 21 of the 23 chromosomes
- Older Paternal Age
- Atypical prenatal development
- Poor social adjustment and academic performance
- Deficient psychomotor functioning
- 20% reduction in life expectancy
54
What are some extrapyramidal antipsychotic med side effects for schizophrenia?
- Tardive Dyskinesia: tongue moves around alot; caused by too much antipsychotic medication
- Akathisia: subjective unpleasant feeling of
restlessness (kinda like a kiddo with ADHD)
- Pseudo-Parkinsonism
- Acute Dystonia
55
What is anti-cholinergic?
Antipsychotic med side effect that causes dry mouth, urinary retention, blurred vision, and constipation
56
T/F: Families of persons with affective disorders are 10x more likely to develop MDD or BMD.
True
57
What are some facts about neuropathology of depression?
- Hedonic Tone: trait or genetic predisposition that affects one’s baseline range and lifelong ability to feel pleasure
- Dysfunction of mesolimbic and mesocortical pathways
- Loss of 40-90% of glial cells
58
Low hedonic tone can increase the risk of which diagnoses?
- anhedonia
- depression
- dysthymia
59
hippocampal neurogenesis
- the brain getting used to the presence of SSRI
- explains 3-6 week lag in tx response time
60
Maternal emotional distress during the first trimester can result in which symptoms in the child?
- Internalization of sxs and negative emotionality in MALES in childhood
- Increase risk of autism, Tourette’s, OCD, and ADHD
61
Maternal emotional distress during the third trimester can result in which symptoms in the child?
Internalizing sxs in FEMALE adolescence
62
T/F: Elevated milk cortisol levels during lactation is associated with more fearful and reactive bx in all infants.
False. Elevated milk cortisol levels during lactation is associated with more fearful and reactive bx in FEMALE infants as compared to male infants
63
What are some brain mechanisms in GAD?
- Reduced connections between amygdala and PFC
- Activation of the vmPFC does not result in reduction of amygdala activation
- Lowered GABA presence in amygdala
64
What are some brain mechanisms in social anxiety?
Disproportionate activation of amygdala when viewing negative expressions and neutral ones
65
What are some brain mechanisms during panic attack?
- Increased activation of amygdala & periaqueductal grey
- Can be induced by the breathing of CO2 and injection of lactic acid
66
How are “Anxious Apprehension” and “Anxious Arousal” different?
- Anxious Apprehension: related to cognitive thoughts and ruminative thinking; increased internal dialogue due to L Frontal lobe activation
- Anxious Arousal: related to physiological anxiety and increased sensitivity to environmental sounds and noises; increased activation in right temporal lobe
67
What's the difference between partial/focal and generalized seizures?
Partial/focal: specific part of the brain is affected
Generalized: both hemispheres of the brain is affected
