Neuro

Question 1

Aso. to decreased levels of dopamine and increased levels of acetylcholine

Answer 1

Parkinson’s Dx

Question 2

resting tremor and bradykinesia most likely has

Answer 2

Parkinson’s Dx

• (a tremor that improves with activity)
• cogwheel rigidity, and a shuffling gait

Question 3

Produce in the sustancia nigra and the ventral tegmental area

Answer 3

Dopamine

Question 4

Tx of Parkinson’s Dx

Answer 4

1) Levodopa is a prodrug that crosses the blood-brain barrier where it is then converted to dopamine.
2) Carbidopa -> prevent peripheral metabolism of the drug.

Question 5

Produce in the basal nucleus of Meynert

Answer 5

acetylcholine

Question 6

locus ceruleus is involved in the synthesis of

Answer 6

Norephinefrine

Question 7

nucleus accumbens is the site of synthesis of

Answer 7

γ-aminobutyric acid (GABA)

Question 8

raphe nucleus is the site of _______ synthesis

Answer 8

Serotonin

Question 9

MOA: Dopamine agonists

Answer 9

• Ergot → bromocriptine

- Non-ergot (preferred) → pramipexole and ropinirole

Question 10

MOA: ↑ dopamine availability

Answer 10

Amantadine

Question 11

MOA:↑ dopamine levels in the brain

Answer 11

Levodopa (L-DOPA)

Question 12

MOA:↑ L-DOPA availability

Answer 12

• Carbidopa (inhibits DOPA decarboxylase)

- Entacapone (inhibits COMT)

Question 13

MOA: dopamine breakdown

Answer 13

• Selegiline (inhibits monoamine oxidase-B)

- Entacapone

Question 14

MOA:↓ cholinergic activity

Answer 14

• Benztropine

- Trihexyphenidyl

Question 15

Associated with lesions along the sympathetic chain

Answer 15

Horner Syndrome

Question 16

Horner Syndrome (1st neuron lesion)

Answer 16

First neuron → pontine hemorrhage, lateral medullary syndrome, spinal cord lesions above T1

Question 17

Horner Syndrome (2nd neuron lesion)

Answer 17

Second neuron → compression of the stellate ganglion by a Pancoast tumor
*Anterior to the transverse process of c7 (stellate ganglion)

Question 18

Horner Syndrome (3nd neuron lesion)

Answer 18

Third neuron → carotid dissection

postganglionic

Question 19

Pancoast tumors are located

Answer 19

in the apex of the lung and can cause Horner syndrome secondary to compression of the stellate ganglion,

Question 20

Additional structures that may be affected by a Pancoast tumor include

Answer 20

• Recurrent laryngeal nerve → hoarseness
• Superior vena cava → superior vena cava syndrome (bilateral symptoms)
• Brachiocephalic vein → brachiocephalic vein syndrome (unilateral symptoms)
• Brachial plexus → sensorimotor deficits