Misc

Question 1

Delirium

Answer 1

Acute, reversible, fluctuating LOC
hypOaroused more common than hypERaroused
“rapidly devleoping, result of disruption to brain homeostasis”
BOTTOM UP - STARTS WITH ATTENTION/AROUSAL TEH LOSE HIGHER FXN

Question 2

Delirium Etiologies

Answer 2

Drugs & Toxins
Metabolic disorders
Infx/Inflammation
Structural lesions (concussion, hematoma, stroke, edema)
Seizure

Question 3

Dementia

Answer 3

Chronic, mostly irreversible, normal LOC and attention
“acquired and persistent”
TOP DOWN, STARTS WITH LOSS OF HIGHER FXNS

Question 4

Dementia Etiologies

Answer 4

Reversible: drugs/toxins
mass lesions
systemic illness
Depression 
Mild TBI
Normal Pressure Hydrocephalus
THEN IRREVERSIBLE IS THE DISEASES plus moderate and severe TBI
Poss treatment: cholinesterase inhibitors and memantine NMDA blocker

Question 5

Subdural Hematoma

Answer 5

banana shape (concave)

Question 6

Epidural Hematoma

Answer 6

lemon/lens shape (convex)

Question 7

Meningitis Triad

Answer 7

Stiff neck
Fever
Depressed consciousness

Question 8

Meningitis CSF profile (Bact)

Answer 8

LOW glucose
HIGH WBC (neutrophils)
HIGH protein

Question 9

Meningitis Bacteria by age

Answer 9

0-2 mos GROUP B STREP
2-23 mos GROUP B STREP/E Coli
2-35 yrs N. meningitidis (meningococcus)
>35 yrs STREP PNEUMONIAE (pneumococcus)
LISTERIA for immunocomprised and over 65s

Question 10

Viral Meningitis vs Viral Encephalitis

Answer 10

Enterovirus, HSV-2
vs
WNV, HSV-1

Question 11

Viral Meningitis CSF profile

Answer 11

HIGH WBC (lymphocytes)
normal glucose
normal protein

Question 12

Encephalitis

Answer 12

Sporadic: HSV2
Epidemic: WNV
Get them on acyclovir, it does not interfere with PCR

Question 13

Spinothalamic Tract

Answer 13

via VPL - pain and temp

Question 14

Spinoreticular Tract

Answer 14

via hypothalamus and amydala - pain and temp, also emotional response

Question 15

Spinomesencepahlic Tract

Answer 15

via midbrain PAG - JUST PAIN - important for descending modulatory influences of pain

Question 16

Capsaicin

Answer 16

Used as analgesic for C-fibers (triggers massive secretion and thus depeltion of substance P)

Question 17

Molecular Receptors

Answer 17

ASIC - acid sening (H+ assoc with injury or pain)
P2X (purinergic, ATP when cells spillguts)
VR-1 (vanilloid, POLYMODAL, temp and vanilloid moiety like capsaicin) - opens non-selective cation channel

Question 18

Triple Response

Answer 18

Red center: BK (activator - gets C fibers to threshold to fire AP, also H+, K+ 5HT - VASODILATION so red)
Wheal: BK (activator)
THESE TWO BK PARTS DO NOT NEED AXONS

Pink senstive flare: SubP (sensitizer - gives smaller depol that brings closer to threshold but no PA, also PGs, 5HT - less VASODILATION so pink )
YES 5HT can be both
THE SUBSTANCE P PARTS DO NEED AN AXON