neuro post midterm Flashcards

1
Q

Atenolol

A

B1 adrenergic antagonist. Tx HTN

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2
Q

Salbutamol

A

B2 adrenergic agonist. Tx asthma (bronchodilator)

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3
Q

Atropine

A

Muscarinic antagonist. Mydriatic, reduction of drooling in Parkinson’s dz, antidote in poisoning with insecticide

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4
Q

Amyotropic lateral sclerosis (ALS)

A

Degeneration of anterior horn cells and V, VII, X, XII, parts of pyramidal tract, and primary motor area. Affects LMNs. Flaccid and spastic paralysis. Affects UEs. Decreased cough reflex -> aspiration pneumonia, respiratory insufficiency

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5
Q

Anterior spinal artery (ASA) syndrome

A

Flaccid paralysis, spastic paresis. Positive Babinski (UMN), lose pain and temp

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6
Q

Central medullary syndrome

A

I.e. syringomyelia d/t tumors. Lose pain and temp, get flaccid paralysis (no spastic paralysis). Common in cervical spine

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7
Q

Posterior parietal cortex

A

Brodmann 5+7, integrate sensory info for motor planning in concert w/premotor areas

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8
Q

Lateral corticospinal tract

A

Mainly flexor. Alpha and gamma. Cortical input. Mainly excitatory

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9
Q

Rubrospinal tract

A

Flexor. Alpha and gamma. Cortical input. Excitatory

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10
Q

Medullary/lateral reticulospinal tract

A

Flexor, bilateral innervation. Alpha and gamma via interneuron. Cortical input. Excitatory

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11
Q

Pontine/medial reticulospinal tract

A

Extensor. Gamma ONLY, via interneuron. Cortical input. Excitatory. Mostly involuntary

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12
Q

Lateral vestibulospinal tract

A

Extensor. Alpha ONLY, via interneuron. NO CORTICAL INPUT. Vestibular organ - excitatory. Cerebellum - inhibitory

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13
Q

Medial vestibulospinal tract

A

Extensor. Alpha ONLY. NO CORTICAL INPUT. Inhibition of alpha (glycine). Vestibular organ - excitatory. Cerebellum - inhibitory

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14
Q

Type I motor unit

A

Slow-twitch; low-tension; fatigue-resistant, aerobic; small motor neuron and axon

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15
Q

Type IIA motor unit

A

Fast; relatively fatigue-resistant; large tension; some aerobic; relatively large motor neurons

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16
Q

Type II B motor unit

A

Fast; fatigue-susceptible; large tension; anaerobic; large motor neurons

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17
Q

Dx and tx for myasthenia gravis

A

Dx - Tensilon test. Tx - azathioprine and corticosteroids - immunosuppressants

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18
Q

Myotonia congenita

A

Defect in gene encoding Cl- channels, can’t bring Em close to Ecl to recover from AP when K+ is accumulating in TTS -> spontaneous firing of muscles after nerve end stimulation. Prolonged relaxation phase

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19
Q

Ballismus

A

Due to lesions of subthalamic nucleus. Decreased excitation of GPi -> disinhibition of thalamus and cerebral cortex -> increased contralateral movement

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20
Q

Tardive dyskinesia

A

D/t antipsychotic drugs (dopamine receptor antagonists), can become permanent

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21
Q

Dopa-induced dyskinesia

A

Occurs in txt of Parkinson’s w/DOPA -> chorea

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22
Q

Drug-induced Parkinson’s disease

A

Antipsychotics, depletors of DA stores (ex reserpine), toxic contaminants (MPTP)

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23
Q

Striatal neuronal degeneration and Huntington’s disease

A

Destruction of striatal neurons expressing D2 receptors -> decreased thalamic inhibition -> increased cortical activity. HYPERKINESIS, CHOREA

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24
Q

Sydenham disease

A

Chorea d/t autoimmune ABs against striatum resulting from childhood rheumatic fever

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25
Q

Mech of L-DOPA and carbidopa

A

L-dopa -> increased dopamine synthesis in surviving SNc. Carbidopa -> decreased peripheral metabolism of L-DOPA. Txt w/L-DOPA and carbidopa becomes less effective over several years

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26
Q

Bromocriptine

A

Stimulates D2 receptors

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27
Q

Pergolide

A

Stimulates both D1 and D2 receptors

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28
Q

Amantadine

A

Antiviral drug, may benefit some manifestations of Parkinson’s (akinesia, rigidity) -> ma promote release of dopamine and/or block ACh receptors (also weakly blocks NMDA receptors). Psychiatric SE’s!

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29
Q

Selegiline (deprenyl)

A

Irreversibly binds MAO B -> may improve responses to or delay need for other therapies

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30
Q

Entacapone and tolcapone

A

Inhibit COMT -> prolong synaptic longevity of dopamine

31
Q

Benztropine

A

Muscarinic antagonist. Block ACh (which has opposite effect of DA on D2) excitation of striatum -> tx resting tremor.

32
Q

Huntington’s disease

A

Tx with D2 receptor antagonists -> antichoreic if there’s still surviving D2 striatal neurons or use VMAT inhibitors -> more free dopamine, less stored in vesicles

33
Q

Louis-Bar syndrome

A

Widespread degeneration of cerebellar Purkinje cells and compromised immune fxn -> delayed development of motor skills, increased vulnerability to infxn, increased sensitivity to ionizing radiation, bloodshot eyes

34
Q

Cerebellar cognitive affective syndrome (CCAS)

A

Cognitive and emotional systems dysfunction resulting from cerebellar injury

35
Q

Guillain-Barre syndrome

A

After respiratory or GI infection. Demyelination of peripheral axons. Good recovery, demyelination. Lumbar puncture -> increased protein in CSF. Tx - immunoglobulin

36
Q

Leprosy (Hansen’s disease)

A

Prefers unmyelinated axons (pain and temperature). Bacterial multiplication -> compression and ischemia of all peripheral axons. Tx w/multiple abx

37
Q

Lead poisoning

A

Focal weakness of extensor muscles of fingers, wrists, and arms. Bilateral arm weakness and wasting in chronic situations. No sensory symptoms. Motor neuropathy in adults and encephalopathy in infants

38
Q

Alcoholic peripheral neuropathy

A

First sensory loss, then motor loss (both symmetric). Vit B1 deficiency

39
Q

Vitamin B1 deficiency

A

Affects rostral vermis and adjacent parts of anterior lobe. Affects cortical Purkinje cells -> reactive gliosis

40
Q

DM

A

Sensory loss (symmetric), motor loss (asymmetric), and autonomic neuropathy. Vasculopathy

41
Q

Cheyne-Stokes respiration

A

Lesion in forebrain

42
Q

Hyperventilation

A

Lesion in midbrain

43
Q

Apneusis (inspiratory cramps)

A

Lesion in pons

44
Q

Ataxic breathing

A

Lesion in lower pons/upper medulla

45
Q

Respiratory arrest

A

Lesion in medulla (bilateral)

46
Q

Diencephalic lesion

A

Small, reactive pupils

47
Q

Uncal herniation

A

One dilated, one constricted

48
Q

Midbrain lesion

A

Midposition, fixed pupils

49
Q

Diffuse effects of drugs, metabolic encephalopathy

A

Small, reactive

50
Q

Pretectal lesion

A

Larged, fixed, unreactive

51
Q

Pontine lesion

A

Pinpoint pupils

52
Q

Alexia

A

Inability to read the left visual field due to dmg in splenium of corpus callosum

53
Q

Phenytoin, carbamazepine

A

Tx epilepsy. Block excitation: reduce flow of Na+ and Ca2+ ions into neurons, increase level of GABA, and suppress the release of glutamate -> less excitability

54
Q

GABAergic, benzodiazepines, barbiturates

A

Tx epilepsy. Enhance inhibition: potentiate inhibitory GABAa recs and inhibit excitatory AMPA recs

55
Q

Levetiracetam

A

Decreases voltage-operated delayed rectifier K+ current w/o effect on Na+ and A-type K+ potassium currents -> reduced repetitive AP generation

Reduction of N-type and P/Q type Ca2+ currents -> decreased NT release

Binds to synaptic vesicle protein, SV2A, which is believed to impede conduction across synapses

56
Q

Thalamocortical transmission part of ARAS

A

Cholinergic structures, monoaminergic systems

57
Q

Lateral hypothalamus, basal forebrain, and cerebral cortex part of ARAS

A

NA, serotonin, histamine, orexin/hypocretin, ACh, GABA

VLPO in hypothalamus - inhibitory (GABA, galanin), promotes sleep by inhibiting activity in the brain’s arousal centers

58
Q

Adenosine

A

Extracellular conc of adenosine rises during waking hours -> inhibits ARAS. During sleep, conc slowly declines. Administration ->NREM sleep

59
Q

Melatonin

A

Extracellular conc reaches a max at about2-3am, and declines to low value by 7am. Synthesis: tryptophan->serotonin->melatonin

60
Q

IL-1

A

Produced during infections. Conc increases in CSF during NREM. Intraventricular injection -> NREM sleep

61
Q

Muramyl peptides

A

From bacterial cell walls. Inject into lateral ventricles of mammals -> NREM sleep

62
Q

Delta sleep-inducing peptide

A

Intraventricular injection -> NREM sleep

63
Q

REM-on cells

A

Maximally active in REM sleep. Use NTs GABA, glycine, ACh, or glutamate

64
Q

REM-off cells

A

Minimally active in REM sleep. Use NTs NE, epi, serotonin, and histamine

65
Q

Storage areas for procedural, non-declarative memory

A

Supplementary and premotor cortex, striatum in BG, cerebellum

66
Q

Late onset Alzheimer’s

A

Chromosome 19 (ApoE/ApoE4) -> failure in Abeta clearance -> gradual increase in Abeta 42

67
Q

Familial Alzheimer’s

A
Chromosone 1 (presenilin 2)
Chromosome 14 (presenilin 1)
Chromosome 21 (APP)

Cause constant production of Abeta 42 (Abeta 43)

68
Q

Histology of Parkinson’s dz

A

Lewy bodies in substantia nigra, locus ceruleus, basal nucleus of Meynert, raphe nucleus, cerebral cortex

69
Q

Histology of Huntington’s chorea

A

Intranuclear and cytoplasmic inclusions/Huntington protein, striatum, frontal cerebral cortex

70
Q

Histology of amyotrophic lateral sclerosis

A

Bunina bodies/SOD1; UMN, LMN, lateral corticospinal tract

71
Q

Pick’s dz

A

Cytoplasmic inclusions, Tau+ Pick bodies composed of densely packed neurofilaments; atrophy in frontal or temporal lobe, cholinergic neuronal loss especially in basal nucleus of Meynert

72
Q

Progressive supranuclear palsy, corticobasal degeneration, frontotemporal dementia

A

Neurofibrillary tangles/tau

73
Q

Progeria

A

LMNA gene normally encodes prelamin A protein. Mutation in LMNA -> production of abnormal form of prelamin A (progerin) -> blebbing and disorganization of nuclear envelope -> impaired signal transduction, nuclear compartmentalization, and gene regulation