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aNeuro exam 4: Lindsey's > LEARN THIS ISH > Flashcards

LEARN THIS ISH Flashcards

1
Q

When does delirium tremens occur in EtOH withdrawal?

A

days 2-8

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2
Q

What are tardive dyskinesias? When is its onset? What is its tx?

A
  • involuntary repetitive movement of lips, tongue with choreoathetoid movements of arms, legs
  • 3-6 months
  • tx = usually permanent so PREVENT THIS FROM HAPPENING
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3
Q

What does D2 receptor block do to the hypothalamus?

A
  • poikilothermia
  • weight gain (bad)
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4
Q

What is the anatomy of the nigrostriatal system?

A

Substantia nigra –> striatum

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5
Q

NT?

motor/movement

drive

A

DA

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6
Q

What is pseudoparkinsonism? When is its onset? What is its tx?

A
  • tremor, bradykinesia, rigidity, shuffling gait
  • 5-90 days
  • tx = Anticholinergic agents or amantadine
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7
Q

What do 5HT + DA together do?

A
  • sex drive
  • appetite
  • aggression
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8
Q

What does increased Mg++ excretion cause?

A

convulsions

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9
Q

What does it mean to be an “atypical” antipsychotic?

A
  • bad D2 block
  • good 5HT2a block
  • good against negative symptoms
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10
Q

What does NE do?

A
  • increases energy
  • increases interest
  • increases motivation
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11
Q

What is the tx for acute EtOH tox?

A
  • supportive + fluids/electrolytes
  • *** thiamine
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12
Q

What meds can help an alcoholic quit?

A
  • disulfram (Antabuse) –> alcohol sensitization
  • Naltrexone (Revia) = opiod antagonis –> reduce craving, consumption, and relapse
  • acamprosate (Campral) = block NMDA receptor –> reduce craving and relapse BUT can mitigate glu hyperexcitability during withdrawal!
  • psychotherapy
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13
Q

What is the anatomy of the mesocortical system?

A

VTA –> prefrontal cortex

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14
Q

What is the tx for acute benzo tox?

A

flumazenil

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15
Q

What NTs are anxiolytic?

A

GABA

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16
Q

Name 2 enzymes needed for EtOH metabolism.

A
  1. aldehyde dehydrogenase
  2. CYP2E1
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17
Q

What NTs cause euphoria?

A
  • DA
  • 5HT
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18
Q

What does D2 receptor block do to the tuberoinfundibular pathway?

A

causes hyperprolactinemia (bad)

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19
Q

What does histamine H1 receptor block do to the CNS?

A
  • weight gain
  • sedation
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20
Q

Which drugs cause weight gain via block of hypothalamic DA receptors?

What do you need to do for your patient?

A
  • atypical antipsychotics
  • monitor weight, blood glucose (checking for DM), and lipids
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21
Q

NT?

increases energy, increases interest, increases motivation

A

NE

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22
Q

How do you treat Parkinson’s?

A
  • elevate dopamine (levodopa, carbidopa)
  • lower muscarinic activity
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23
Q

What does it mean to be a “typical” antipsychotic?

A
  • good D2 block
  • less 5HT2a block
  • good against positive symptoms
  • bad side effects from blocking D2 (EPS)
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24
Q

This is for somatosensory of the body.

A

VPL

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25
Q

Dx? What drug could have caused this?

tremor, bradykinesia, rigidity, shuffling gait.

A
  • pseudoparkinsonism
  • via Haloperidol
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26
Q

This is for hearing (m for music).

A

medial geniculate nucleus (MGN)

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27
Q

What is dystonia? When is its onset? What is its tx?

A
  • Torticollis, swollen tongue, trismus, oculogyric crisis, opisthotonos.
  • 1-5 days
  • tx = antimuscarinics (diphenhydramine, benztropine)
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28
Q

What NTs cause altered perception?

A

5HT

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29
Q

What does the lateral geniculate nucleus (LGN) do?

A

vision (L for light)

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30
Q

What does DA do?

A
  • motor/movement
  • drive
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31
Q

What does D2 receptor block do to the nigrostriatal pathway?

A

increases extrapyramidal SEs –> parkinsonianisms (bad)

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32
Q

What does D2 receptor block do to the mesocortical pathway?

A

increases the negative symptoms (bad)

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33
Q

What does increased blood lactate cause?

A
  • acidosis
  • behavioral disturbances
34
Q

Where does the VA/VL project and what’s it important for?

A

from the cerebellum and from the basal ganglia –> cortex movement

35
Q

Outcomes of hyperprolactinemia?

A
  • galactorrhea***
  • decreased libido, sexual dysfunction, erectile dysfunction, infertility, amenorrhea, and gynecomastia
36
Q

What does the VPM do?

A

somatosensory of the face (makeup on your face)

37
Q

NT?

drives impulses

A

5HT

38
Q

What does decreased uric acid excretion cause?

A

gout

39
Q

What does D2 receptor block do to the chemoreceptor trigger zone?

A

causes an anti-emetic effect (good!)

40
Q

What does muscarinic cholinergic block do to the ANS?

A
  • NO PEE, NO SEE, NO SPIT, NO SHIT
  • difficulty urinating
  • blurred vision
  • dry mouth
  • constipation
41
Q

NT?

mood

emotion

cognitive function

A

5HT + NE + DA together

42
Q

What is the mechanism of action for dissociative anesthetics?

A

antagonist at NMDA-glu receptors

43
Q

What does muscarinic cholinergic block do to the CNS?

A

causes a toxic confusional state

44
Q

What is akathisia? When is its onset? What is its tx?

A
  • Motor restlessness, inability to sit still (not anxiety or agitation)
  • 6-60 days
  • tx = difficult. Reduce dose or change drug; add anticholinergic and / or possibly β- blocker, benzodiazepines.
45
Q

What does 5HT do?

A

drives impulses

46
Q

What does increased Acetyl CoA cause?

A

increased fatty acid synthesis –> decreased fat breakdown –> fatty liver

47
Q

What does the VPL do?

A

somatosensory for the body

48
Q

What does alpha-1 receptor block do to the ANS?

A
  • orthostatic hypotension
  • impotence
  • failure to ejaculate
49
Q

What is the anatomy of the mesolimbic system?

A

VTA –> NA

50
Q

What NTs cause CNS stimulation?

A
  • DA
  • NE
  • ACh
51
Q

What NTs/channels in the brain cause cravings?

A
  • DA
  • NMDA
52
Q

This is the ability of one drug to suppress the withdrawal of another; act at the same target.

A

cross-dependence

53
Q

Where is dopamine synthesized? What’s its final destination?

A
  • synthesis in the VTA *** think VTA to DA
  • final dest = nucleus accumbens (NA)
54
Q

NT?

sex drive

appetite

aggression

A

5HT + DA together

55
Q

How does cocaine work?

A

it blocks DA reuptake

56
Q

When do seizures occur in EtOH withdrawal?

A

immediately –> 4 days

57
Q

What is Stevens-Johnson syndrome?

A
  • hypersensitivity where cell death causes separation of dermis from epidermis
  • SE of carbamazepine***
58
Q

How do you treat drug-induced Parkinson’s in a schizo pt?

A

lower anti-muscarinic activity - give anticholinergics like diphenhydramine or benztropine

59
Q

The rate of onset of anesthetics is ______ to blood solubility.

A

inversely proportional - more soluble in blood = SLOWER onset

60
Q

What do 5HT + NE + DA together do?

A
  • mood
  • emotion
  • cognitive function
61
Q

This is for vision (L for light).

A

lateral geniculate nucleus (LGN)

62
Q

What is the tx for opioid withdrawal?

A
  • clonidine
  • methadone
63
Q

What is an interference in body temperature regulation at the hypothalamus called?

A

poikilothermia

64
Q

What is the tx for CNS stimulant withdrawal?

A

behavioral modifications

65
Q

What does increased NADH cause?

A

decreased Krebs –> decreased gluconeogenesis –> hypoglycemia***

66
Q

What is the tx for acute barb tox?

A

supportive

67
Q

What factors influence the rapidity of onset of anesthetic action?

A
  • concentration in inspired air (increased = increased rate)
  • solubility (increased = slower rate)
68
Q

What does D2 receptor block do to the mesolimbic pathway?

A

decreases positive symptoms (good!)

69
Q

What causes fatty liver?

A

EtOH –> increased Acetyl CoA –> increased fatty acid synthesis –> decreased fat breakdown –> fatty liver

70
Q

ALL drugs of abuse, at some point, enhance _____.

A

dopamine

71
Q

What is the anatomy of the tuberoinfundibular system?

A

hypothalamus –> pituitary (decreased prolactin release, poikilothermia, increased eating)

72
Q

Dx? What drug could have caused this?

involuntary repetitive movement of lips, tongue with choreoathetoid movements of arms, legs

A
  • tardive dyskinesias
  • via Haloperidol
73
Q

What is the medial geniculate nucleus (MGN) for?

A

hearing (M for music)

74
Q

What is cross-dependence?

A

ability of one drug to suppress the withdrawal of another; act at the same target

75
Q

Dx? What drug could have caused this?

Torticollis, swollen tongue, trismus, oculogyric crisis, opisthotonos.

A
  • dx = dystonia
  • via Haloperidol
76
Q

This is for somatosensory of the face (makeup on your face).

A

VPM

77
Q

What is the tx for EtOH withdrawal?

A
  • benzos (chlordiazepoxide, lorazepam)
  • α2 adrenergic agonist (clonidine)
78
Q

What is neuroleptic malignant syndrome? What is the tx?

A
  • catatonia, stupor, fever, unstable blood pressure
  • malignant hyperthermia
  • tx = sodium dantrolene
79
Q

Dx? What drug could have caused this?

Motor restlessness, inability to sit still (not anxiety or agitation)

A
  • akathisia
  • via Haloperidol
80
Q

What does 5HT2a receptor block do to the mesocortical pathway?

A
  • decreases negative symptoms (good)
  • causes weight gain
81
Q

What do 5HT + NE together do?

A
  • anxiety
  • irritability

aNeuro exam 4: Lindsey's (37 decks)

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