Neuro

Question 1

Name all portions of the limbic system (4)

Answer 1

1. Amygdala
2. Hippocampus
3. Anterior Cingulate
4. Cerebellum

Question 2

Focuses on
a. aggression
b. fear/anxiety
c. emotions

Answer 2

What does the amygdala do?

Question 3

It focuses on emotions, stress, learning, and memory.

Answer 3

What does the hippocampus do?

Question 4

This part of the brain focuses on cognitive function, decision making, empathy/impulse, and emotions?

Answer 4

Anterior cingulate

Question 5

It focuses on maintenance of balance and posture.

Answer 5

What does the Cerebellum do?

Question 6

Depression in older adults.
Symptoms also include irritability, agitation, hallucinations, and delusionals

Answer 6

Pseudodementia definition

Question 7

What kind of screening should you do for pseudodementia?

Answer 7

Do cognitive screening.
Primary dx is depression and they are often confused with dementia related symptoms.

Question 8

Early signs of HIV dementia

Answer 8

1. Cognitive decline
2. Motor + Behavioral abnormalities

Question 9

What are the steps to do with a patient who has early signs of HIV dementia from IV drug use?

Answer 9

1. Order HIV test
2. Then remove anti-retroviral therapy treatment.
3. Refer PCP.

Question 10

This is a brain disorder that can lead to problems with thinking, movement, behavior, and mood.
Common symptom is recurrent VH.

Answer 10

Lewy Body disease

Question 11

Pick’s disease is what part of the brain?

Answer 11

1. Frontotemporal (dementia)
2. Frontal Lobe (dementia)

Question 12

1. Personality
2. Behavioral
3. Language changes
4. Also effects social skills

Answer 12

Early stages of Pick’s disease

Question 13

What does frontal lobe dementia cause?

Answer 13

It causes inappropriate social behavior and aggression.

Question 14

Huntington’s Disease is also known as?

Answer 14

Subcortical Dementia

Question 15

Huntington’s disease is characterized by what?

Answer 15

1. Mostly characterized by motor abnormalities.
2. Psychomotor slowing and difficulty with complex tasks.

Question 16

What is produced in the locus coruleus and medullary reticular formation

Answer 16

Where is norepinephrine produced?

Question 17

Raphe nuclei of the brainstem

Answer 17

Where is serotonin produced?

Question 18

1. Substantia nigra (regulates motor movement)
2. Ventral tegmental area (VTA)
3. Nucleus Accumbens

Answer 18

Where is Dopamine produced?

Question 19

Is synthesized by the basal nucleus of Meynert.

Answer 19

Acetylcholine-where is it synthesized?

Question 20

What are the four dopamine pathways?

Answer 20

1. Mesolimbic
2. Mesocortical
3. Nigrostriatal
4. Tuberoinfundibular

Question 21

Hyperactivity of dopamine mesolimbic pathway mediates what?

Answer 21

It mediates positive psychotic symptoms.

Question 22

Decreased dopamine in the mesocortical pathway is responsible for what?

Answer 22

It is responsible for negative and depressive symptoms of schizophrenia.

Question 23

Mesocortical pathway is projected where?

Answer 23

Dorsolateral prefrontal cortex.
(Meso and dorso kinda rhyme)

Question 24

Nigrostriatal pathway is responsible for what?

Answer 24

It mediates motor movements.

Question 25

Dopamine blockage in the nigrostriatal pathway can lead to what increased neurotransmitters? And what symptoms does it cause?

Answer 25

1. Increased acetylcholine levels. 2. Increased salivation, teary eyes, and akathisia.

Question 26

In the nigrostriatal pathway, what can metoclopramide (Reglan) cause?

Answer 26

It can cause EPS symptoms like TD and parkinsonism.

Question 27

Increase in acetylcholine and decrease dopamine levels. This can lead to what?

Answer 27

EPS

Question 28

Blockage of D2 receptors in this *pathway* can lead to increase prolactin levels which lead to hyperprolactinemia.

Answer 28

Tuberoinfundibular pathway

Question 29

Due to the tuberoinfundibular pathway, high levels of prolactin, this can include symptoms of? (4 of them)

Answer 29

1. Amenorrhea 2. Galactorrhea 3. Sexual dysfunction 4. Gynecomastia

Question 30

Long-term hyperprolactinemia can be associated with what?

Answer 30

Osteoporosis

Question 31

Prolactin levels Men and Women

Answer 31

Men = less than 20ng/ml Women = less than 25ng/ml

Question 32

Positive symptoms from excess dopamine between VTA and NA, antipsychotics decrease dopamine and therefore decrease positive symptoms (hallucinations).

Answer 32

Mesolimbic pathway

Question 33

Dopamine going from VTA to cortex schizophrenia = decreased dopamine = negative symptoms (pleasure, facial expression, emotion)

Answer 33

Mesocortical pathway

Question 34

Dopamine going from Substantia Nigra to Striatum = mediates motor movements. We induce PARKINSONIAN symptoms if antipsychotic makes dopamine decrease.

Answer 34

Nigrostrial pathway

Question 35

Parkinsonian symptoms and treatment

Answer 35

Decreased dopamine = cog wheel rigidity, resting tremors, shuffling gait. Treatment = anticholinergic

Question 36

Pathway between hypothalamus and pituitary gland

Answer 36

Tuberoinfundibular pathway

Question 37

In the Tuberoinfundibular pathway Too much dopamine = ??

Answer 37

Decreased prolactin

Question 38

Tuberoinfundibular pathway Decreased dopamine =??

Answer 38

Increased prolactin which also = galactorrhea and amenorrhea

Question 39

EPS symptoms include: (4 of them)

Answer 39

1. Dystopia 2. Akathesia 3. Parkinsonism 4. TD

Question 40

Dystonia symptoms and tx

Answer 40

1. Sustained muscular contraction 2. Ocuogynic crisis 3. Treatment = anticholinergic

Question 41

Akathesia definition and treatment

Answer 41

1. Restlessness, pacing, tapping (ants in the pants) 2. Treatment = beta blockers

Question 42

Tardive Dyskinesia symptoms and treatment

Answer 42

1. Lip-tongue smacking, repetitive, & uncontrolled. 2. Treatment = d/c antipsychotic and +/- Clozapine

Question 43

Neurological Malignant Syndrome symptoms

Answer 43

1. Confusion 2. Muscle rigidity 3. Fever 4. Tachycardia

Question 44

NMS causes rhabdo. What Labs to check?

Answer 44

1. CK 2. K 3. WBCs