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EXAM > Neuro/pharm > Flashcards

Neuro/pharm Flashcards

1
Q

Norepinephrine: change in dz

A

A neurotransmitter that activates the sympathetic response to stress, increasing heart rate (HEART) , rate of respiration, and blood pressure in support of rapid action. Also known to excite the INTESTINES and UROGENITAL tract. Low amounts are linked to depression, manic behavior.
Norepinephrine inhibits the firing of neurons in the central nervous system, but it excites the HEART muscle, INTESTINES, and UROGENITAL tract. Stress stimulates the release of norepinephrine. This neurotransmitter also helps to control alertness. Too little norepinephrine is associated with depression, and too much triggers agitated, manic states. For example, amphetamines and cocaine cause hyperactive, manic states of behavior by rapidly increasing brain levels of norepinephrine.

Increase anxiety
Decrease depression

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2
Q

Dopamine: describe change in dz

A

Neurotransmitter that influences voluntary movement, attention, alertness; lack of dopamine linked with Parkinson’s disease; too much is linked with schizophrenia. Low levels are associated with Parkinson’s Disease where the physical movement is deteriorated. High levels are associated with Schizophrenia.Increase hodgkins dz
Decrease Parkinson’s
Decrease depression

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3
Q

5-HT (serotonin receptor)

A

A neurotransmitter that affects hunger,sleep,arousal,and mood. appears in lower than normal levels in depressed persons. Teams with acetylcholine and norepinephrine. Lowered levels of Serotonin area associated with depression. contributor to feelings of well-being and happiness

Increase Parkinson’s
Decrease anxiety
Decrease depression

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4
Q

Ach, describe change in dz

A

Neurotransmitter used to control activity, including movement, memory, attention, and dreaming. Usually stimulates the firing of neurons. Low levels are linked to Alzheimers Disease

Increase Parkinson’s
Decrease Alzheimer’s
Decrease Huntington dz

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5
Q

GABA, describe change in dz

A

Found in the central nervous system and keeps neurons from firing to help control signals being carried from one neuron to the next. 1/3 of the brains synapses. Low levels are linked to anxiety.
Reduces neural excitability
Decrease anxiety
Decrease Huntington dz

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6
Q

Describe Parkinson’s dz

A

Degenerative disorder of CNS associated with Lewy bodies and loss of dopaminergic neurons (de pigmentation) of substantial nigra.

TRAPS your body- Tremor, cogwheel Rigidity, Akinesia, Postural instability, Shuffling gait

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7
Q

Describe huntington dz

A

Autosomal dominant trinucleotide repeat disorder on chromosome 4. Age 20-50 with aggression, depression, dementia. Decrease levels of GABA and Ach in the brain.

Caudate loses Ach and GABA

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8
Q

Describe alpha 1 adrenergic receptor. G protein class? Major fxns

A

ActivAtion in smooth muscle a
Of blood vessels to leads to vasoconstriction of both arteries and veins leading to increase BP seen in sympathetic response (INCREASE VASCULAR SMOOTH MUSCLE). INCREASE PUPILLARY DILATOR MUSCLE. INCREASE INTESTINAL AND B,ADDER SPHINCTER

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9
Q

Describe alpha 2 adrenergic receptor. G protein class, Major fxns

A

i. Decrease SMPATHETIC OUTFLOW (inhibit norepi). Decrease INSULIN RELEASE, LIPOLYSIS. increase PLATELET AGGREGATION.

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10
Q

Describe beta 1 adrenergic. G protein class, major fxns

A

s. Increase HR ( at the SA node. Chronotropic effects and leads to increased cardiac output), contractility, renin release, LIPOLYSIS

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11
Q

Describe beta 2 adrenergic. G protein class, major fxns

A

s. Vasodilation, bronchodilation

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12
Q

Describe -azole. Category. Example

A

Antimicrobial. Ergosterol synthesis inhibitor. I.e. Ketoconazole

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13
Q

-bendazole. Category. Example

A

-bendazole. Antimicrobial. Anti parasitic. I.e. Mebendazole

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14
Q

-cillin. Category. Example

A

Peptidoglycan inhibitor. Antimicrobial. I.e. Penicillin/ampicillin

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15
Q

-cycline. Describe. I.e.

A

Antimicrobial. Protein synthesis inhibitor. Tetracycline

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16
Q

-ivir. Describe. I.e.

A

Antimicrobial. Neuraminidase inhibitor. I.e. Oseltamivir

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17
Q

-navir. Describe. I.e.

A

Protease inhibitor i.e. Ritonavir

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18
Q

-ovir. Describe. I.e.

A

DNA polymerase inhibitor i.e. Acyclovir

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19
Q

-thromycin. Describe. I.e.

A

Antimicrobial. Macrolides antibiotic i.e. Azithromycin

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20
Q

Hindbrain

A

Division which includes the cerebellum, Pons, and medulla; responsible for INVOLUNTARY processes: blood pressure, body temperature, heart rate, breathing, sleep cycles.

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21
Q

Brainstem

A

The part of the brain that controls functions including HEART rate, BREATHING, and BODY TEMP; includes midbrain, pons, and medulla oblongata. Connects the spinal cord at its lower end and then extends upward to encase the reticular formation of the mid brain.

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22
Q

Midbrain

A

A small structure between the hindbrain and forebrain that relays information from the EYES, EARS, and SKIN and that controls certain types of automatic behavior. Nerve fiber systems ascend and descend to connect the higher and lower portions of the brain.

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23
Q

forebrain

A

The brain’s largest division and its most forward section. Top of the brain which includes the thalamus, hypothalamus, and cerebral cortex; responsible for EMOTIONAL REGULATION, COMPLEX THOUGHT, MEMORY ASPECT OF PERSONALITY.

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24
Q

limbic system

A

A doughnut-shaped system of neural structures at the border of the brainstem and cerebral hemispheres; associated with emotions such as FEAR and AGGRESSION and drives such as those for food and sex. Includes the hippocampus, amygdala, and hypothalamus. A loosely connected network of structures under the cerebral cortex.

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25
Q

Describe ACE inhibitors, give examples and Side effecs

A

inhibit conversion of angiotnsin I to angiotensin II, decreasing aldosterone and sodium/water intake to decrease BP.

ie. -pril lisinopril

side effects: release of bradykinin which is a vasodilator causing a DRY (NON PRODUCTIVE) COUGH.

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26
Q

describe beta blockers, what class, give examples, and contraindiciations

A

Class II drugs. decrease HR and speed of conduction.

ie. atenelol, metropolol –> cardioselective
propanolol –> non-cardioselective

CONTRAINDICATIONS- CHF, asthma, diabetes, heart block

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27
Q

describe HCTZ

A

thiazide, diuretic. Inhibit Na reabsorption causing loss of Na. DANGER: can cause hypoKALEMIA causing muscle problems

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28
Q

describe verapamil, nifedipine, amlodipine. What class of drugs are these?

A 
Ca Channel BLocker, class IV. inhibit Ca from smooth muscle and myocardium during depolarization. produces relaxation of coronary smooth muscle. 
SIDE EFFECTS: constipations, flushing edema, CV effects
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29
Q

describe mechanism of nitroglycerin, isosorbide, dinitrate.

A

Endothelial cell produce NO–> A guanyl cyclase –> GTP –> CAMP–> De-P of light chain myosin –> RELAXATION of all smooth muscle–> dilation of veins/arteris to DECREASE prelaod, O2 demand.

DANGER: reflex tachycardia & increase PR! use with beta blockers

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30
Q

Name the 6 lipid lowering drug groups

A

Ezetimibe, statins, niacin, bile acid resins, fibrates, cardiac glycosides.

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31
Q

name the 12 cranial nerves

A

you know these

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32
Q

name nerves for eyes

A

you know these

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33
Q

describe pathway for V1 of which nerve?

A

trigeminal. V1: cavernous sinus–> superior orbital fissure–> orbit.

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34
Q

describe pathway for V2 of which nerve

A

trigeminal. V2–> rotundum–> pterygopalatine fossa –> all things maxillary

35
Q

describe pathways for V3 of which nerve

A

trigeminal. V3–> ovale –> infratemporal fossa–> all things mandibular.

36
Q

name 9 movement disorders

A

Hemiballismus, chorea, athetosis, dystonia, essential tumor, resting tremor, intention tremor

37
Q

which movement disorder is associated with wild flailing with ipsilateral leg movement

A

hemiballismus

38
Q

which movement disorder shows sudden jerky purposeless movement. where it is found?

A

chorea= dancing. found in basal ganglie (voluntary movement/ postural stance)

39
Q

athetosis?

A

wrthing movements especially in fingers, snake-like

40
Q

resting tremor

A

uncontrolled movements of distal appendages like hands. seen in parinsons.

41
Q

describe epidural hematoma

A

rupture of middle meningeal artery (branch of maillxary artery). NOT cross surture lines

42
Q

describe subdural hematoma

A

rupture of BRIDGING VEINS. SLOW venous bleeding, CROSSES suture lines.

43
Q

describe subarachnoid hematoma

A

rupture of ANEURYSM. assocaited with MARFAN, EHLERS DANLOS. “worst headache of my life”

44
Q

what is term for acute blockage of vessels which can result in liequfactive necrosis. name 3 types

A

ischemic stroke. 3 types: thrombotic, embolic, hypoxic. thrombotic at direct site (usually MCA), emobolic (usually from cardioembolic).

45
Q

Name the 6 adult primary brain tumors. (GM, Mioma,Hblastoma, Schwan, oligo, PA. )

A

glioblastoma multiforme, meningioma, hemangioblastoma, schwannoma, oligodendroglioma, pituitary adenoma.

46
Q

Name the 4 childhood primary brain tumors

A

pilocytic astrocytoma, medulloblastoma, ependymoma, craniopharygnioma

47
Q

Describe the 4 kinds of meningomyelocele

A

Normal. Spins bifida occulta (failure of bony spine to close, assoc with tuft of hair), meningocele (meninges herniated through spinal canal), meningomycelocele (meninges and spinal cord herniated through spinal canal).

48
Q

Name the 6 big Neurotransmitters and location

A

Norepinephrine( pons), dopamine (midbrain), 5HT (raphe nucleus), Ach (basal nucleus of Meyers), GABA (nucleus accumbens).

49
Q

Describe change in dz of Norepi and dopamine

A

Norepi=HIGH in anxiety, LOW in depress

Dopamine= HIGH huntingtons, LOW in parkinson, LOW depression

50
Q

Describe change of dz in 5HT and aCh, GABA

A 
5HT= HIGH in parkinson, LOW anxiety and depress
Ach= HIGH in parkinson, LOW in Alzheimer's, LOW huntingtons
GABA= LOW anxiety, huntingtons
51
Q

Describe hypothalamus

A

TAN HATS

Thirst, Adenohypophysis neurohypophysis, hunger, autoimmune, temperature, sexual urges

52
Q

Describe REM sleep

A 
"At night, BATS Drink Blood"
Beta- awake eyes open
Alpha- awake eyes close
Theta- Light sleep
Sleep spindles and K complexes- deeper sleep
Beta- R.E.M. Sleep loss of motor tone.
53
Q

Describe limbic system

A

The Famous F’s

Feeding, fleeing, fighting, feeling, fucking

54
Q

Describe kluver Bucy syndrome, wenicke korsakoff syndrome

A

Kluver bucy due to bilateral amygdala lesion. Wernicke due to thiamine B1 deficiency. Wernicke comes in CAN of beer (confusion, ataxia, nystagmus).

55
Q

Describe conduction, transcortical motor, transcortical sensory, and mixed transcortical brain lesions.

A
  1. Conduction CAN speak, CANT repeat
  2. Transcortical motor CAN comprehend, CAN repeat
  3. Transcortical sensory CAN speak, CANT comphrend, CAN repeat
  4. Mixed transcortical CANT speak, CANT comprehend, CAN repeat.
56
Q

Draw out circle of willis

A

Draw

57
Q

Describe Acomm and Pcomm effects of strokes

A

Acomm most common lesion is aneurysm. Saccular berry aneurysm can impinge on cranial nerves causing visual defects
Prom common site of saccular aneurysm causing CN III palsy

58
Q

Describe Berry aneurysm

A

Most common site is junction of anterior communicating and anterior cerebral artery. Described “Worst headache of life”

59
Q

Describe the types of intracranial hemorrhages

A

Epidural (rupture of middle meningeal a., doesn’t cross suture lines, cross falx tentorium).
Subdural (slow bleed, can cross suture lines, cannot cros falx tentorium)
Subarachnoid (rupture of an aneurysm seen in Marfan, ehler danlos)
Intraparenchymal (systemic hypertension)

60
Q

Draw out dural venous sinuses

A

Draw

61
Q

Describe hydrocephalus

A

Communication (nonobstructive)=

  1. normal “wet, wobbly, wacky”
  2. Hydrocephalus ex vacuum INCREASE in CSF in atrophy with normal intracranial pressure.
  3. Communicating DECREASE in CSF and INCREASE in intracranial pressure
62
Q

Describe findings of MS

A

INCREASE protein IgG in CSF. Periventricular plaques with destruction of axons.

63
Q

What are the 4 big neurocutaneous disorders

A

Sturge-Weber syndrome
Tuberous sclerosis
Neurofibromatosis Type I (Von recklinghausen)=cafe au lait spots, lisch nodules
Von hippel Lindau

64
Q

List the 4 NeuroCutaneous disorder

A

Sturge-Weber syndrome, tuberous sclerosis, Neurofibromatosis Type 1 (Von Recklinghausen dz), Von hippel Lindau

65
Q

Describe Skeletal, cardiac, ocular, pulmonary, skin Characteristics of Marfans Syndrome. Mutation of what?

A 
Mutation of Fibrillin-1 which is req'd for tissue elasticity and integrity. 
SKELETAL: body habitus
OCULAR: ectopic lentils
PUMLONARY: pneumothorax
SKIN: incisional hernia
66
Q

Sturgeon Weber Syndrome

A

“STURGE” Sporadic (not inherited but random), port-wine Stain, Tram Track Ca2+ (leptomeningeal angioma calcifications), Unilateral, Retardation, Glaucoma, Epliepsy

67
Q

Tuberous Sclerosis

A

“HAMARTOMAS” Hamartoma in CNS, Angiofibromas everywhere on skin, Mitral Regurgitate, Ash-leg spots, cardiac Rhabdomyoma, (Tuberos sclerosis), autosomal dOminant, Mental retardation, Angiolipla (histologically), Seizures, Shagreen patches

68
Q

Neurofibromatosis 1 (Von recklinghausen dz)

A

Mutated NF1- gene. Neurofibromas of Schwann cell origin from neural crest cells. Cafe au lait spots, lisch nodules in eye (pigmented iris hamartoma),

69
Q

Name the 6 spinal cord lesions..

A 
Poliomyelitis
MS
Lateral sclerosis
Tabes dorsalis
Syringomyelia***
B12 or Vit E deficiency
70
Q

Poliomyelitis

A

LMN lesion ONLY. Fall is paralysis

71
Q

MS

A

Due to demyelination. Random asymmetric lesions. “Charcot triad is a SIN” Scanning speech, intention tremor, nystagmus. IgG in CNS

72
Q

Lateral Sclerosis

A

Combined UMN/LMN deficits with no sensory, cognitive, or oculomotor deficitis. Stephen Hawking.

73
Q

Tabes Dorsalis

A

Caused by tertiary syphyllis. Degneration of dorsal column and roots–> impaired sensation and propriorception. Associated with Charcot joints, argyle Robertson pupils (small bilateral pupils that further constricts to accomodate, not to light). absence of DTR, + Rhomberg (close eyes and stand with feet together, can’t maintain balance)

74
Q

syringomyelia**

A

Cavitation expansion of central canal impeding on white commisure anterior cape distribution. Bilateral loss of pain and temp C8-T1. Seen with Chiari I malformation.

75
Q

B12 or Vit E deficiency spinal cord lesion

A

Patchy demyelination! Not fully. - Rhomberg, pernicious anemia

76
Q

Function of dorsal column

A

Ascending: pressure, vibration, fine touch, proprioception. 1 synapse: n. Cuneatus or gracious

77
Q

Function Spinothalamic tract

A

Ascending: latera: pain/temp anterior: crude touch, pressure. 1 synapse gray matter

78
Q

Function: lateral corticospinal tract

A

Descending: voluntary movement of contralateral limbs.

79
Q

Brown Sequard syndrome

A

Hemisection. Of spinal cord. Impaired contralaeral pain/temp sensations (due to spinothalamic tract damage). Impaired ipsilateral propriorception, vibration, joint and position sensation (due to dorsal column damage)

80
Q

Horner syndrome

A

Sympathoectomy of the face. “PAM is HORNy (Horner) Ptosis (slight dropping of eyelid), Anhidrosis( absence of sweating), Miosis (pupil constriction).

81
Q

Right anopia

A

…

82
Q

Bitemporal hemaniopia

A

Pituitary lesion, chiasm. “Tunnel vision”

83
Q

Left homonymous hemianopia

A

Cute right before LGN

84
Q

Macular degeneration

A

AKA central scotoma. Deficit in center of affected eye.

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