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Step 1 > Neurology > Flashcards

Neurology Flashcards

1
Q

when does notochord becomes nucleus pulposus?

A

day 18

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2
Q

alar plate

basal plate

A

a - dorsal - sensory

b - ventral - motor

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3
Q

what is in the hindbrain?

A

pons, cerebellum, medulla, 4th ventricle

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4
Q

what does neural mesoderm become?

A

microglia (like mpgs)

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5
Q

what do neural crest cells become?

A

PNS neurons, schwann cells

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6
Q

high AFP in amniotic fluid and mothers blood

A

neural tube defect

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7
Q

what is a helpgul confirmation test of neural tube defects?

A

high AChE in amniotic fluid

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8
Q

spina bifida occult

what do you see?

A

failure of bony spinal canal to close, but no herniation
intact dura
tuft of hair and skin dimple in lower back

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9
Q

meningocele

A

meninges herniate through bony defect

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10
Q

meningomyelocele

A

meninges and neural tissue herniate through bony defect

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11
Q

anencephaly

RF

A

no forebrain, open calvarium

DM1, low folate

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12
Q

holoprosencephaly

may be an issue with

A

failure of hemispheres to seperate

sonic hedgehog pathway

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13
Q

chiari II malformation

associated with

A

herniation of cerebellum through foramen magnum –> hydrocephalus
meningomyelocele

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14
Q

Dandy-Walker syndrome

Associated with

A

agenesis of cerebellar vermis
cystic enlargement of 4th ventricle
non communicating hydrocephalus, spina bifida

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15
Q

syringomyelia

A

cystic cavity in spinal cord affecting spinothalamic first

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16
Q

cape like bilateral loss of pain and temperature

A

syringomyelia

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17
Q

Chiari I malformation

see

A

cerebellar tonsillar ectopia

cerebellar symptoms, headache

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18
Q

function genioglossus

A

sticks tongue out

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19
Q

function hyoglossus

A

retracts and flattens tongue

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20
Q

styloglossus function

A

curls tongue for swallowing

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21
Q

extreme posterior innervation of tongue

A

X

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22
Q

nissl staining stains

A

RER

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23
Q

astrocytes
derived from
function
marker

A

neuroectoderm
repair, K metabolism, XS NT removal, BBB, glycogen fuel reverse buffer, reactive gliosis
GFAP

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24
Q

HIV microglia

A

fuse forming multinucleated giant cells

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25
Q

Myelin
CNS
PNS
difference

A

oligodendrocytes - can myelinate < 30 axons

schwann cells - only 1 axon

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26
Q

fried egg cell in CNS

Injured in

A

oligodendrocyte

MS, PML, leukodystrophies

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27
Q

C fibres

A

slow, unmyelinated

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28
Q

Ad fibres

A

fast, myelinated

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29
Q

free nerve endings

function

A

C, Ad

Pain, temperature

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30
Q

where are meissner corpuscles found?

what do they sense?

A

hairless skin

fine/light touch, position sense

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31
Q

where are pacinian corpuscles found?

what do they sense?

A

deep skin, ligaments, joints

vibration, pressure

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32
Q

where are merkel discs?

what do they sense?

A

finger tips, superficial skin

pressure, deep touch, position sense

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33
Q

where are ruffini corpsucles?

what do they sense?

A

finger tips joints

pressure, movement of objects, joint angle change

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34
Q

large, myelinated fibres adapting quickly

A

meissner, pacinian

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35
Q

large, myelinated fibres aadpting slowly

A

merkel discs

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36
Q

dendritic endings with capsule, adapting slowly

A

ruffini corpuscles

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37
Q

In GBS where is the inflammation?

A

endoneurium

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38
Q

where is ACh synthesised?

A

basal nucleus of meynert

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39
Q

when is DA decreased, increased

A

d - depression, parkinson’s

i - schizophrenia, huntingdon’s

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40
Q

where is GABA made?

when is GABA decreased?

A

nucleus acumbens

anxiety, Huntingdon’s

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41
Q

when is NE increased, decreased?

made in

A

i - anxiety
d - depression
locus ceruleus

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42
Q

where is seratonin made?

A

raphe nucleus

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43
Q

what forms the BBB?

A

capillary endothelial cells, basement membrane, astrocyte foot procesess

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44
Q

which areas don’t have the BBB?

A

area postrema - medulla, responds to emetics

OVLT

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45
Q

area postrema

A

medulla, responds to emetics

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46
Q

OVLT

A

organum vasculosum of the lamina terminalis

senses change in osm

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47
Q

what does the supraoptic nucleus make?

paraventricular

A

ADH

oxytocin

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48
Q

lateral area of hypothalamus

A

hunger

ghrelin and leptin

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49
Q

ventromedial hypothalamus

A

satiety

leptin

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50
Q

craniopharyngioma affects

A

ventromedial hypothalamus

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51
Q

anterior hypothalamus

A

cooling, PANS

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52
Q

posterior hypothalamus

A

heating, SANS

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53
Q

suprachiasmatic nucleus of hypothalamus

A

circadian rhythm

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54
Q

circadian rhythm controls release of

A

ACTH, prolctin, melatonin, NE

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55
Q

how is melatonin released?

A

NE –> pineal gland

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56
Q

what causes REM sleep?

A

PPRF activity

paramedian pontine reticular formation

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57
Q

What is increased in REM?

A

ACh

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58
Q

what decreases REM sleep?

A

alcohol, benzodiazapines, barbituates, NE

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59
Q

stages of sleep

A

at night BATS Drink Blood

Beta, alpha, theta, sleep spindles and K complexes, Delta, Beta

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60
Q

light sleep

A

theta

5%

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61
Q

deeper sleep, bruxism

A

sleep spindles, K complexes

45%

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62
Q

deepest non-REM

A

delta
25%
sleepwalking, night terrors, bedwetting

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63
Q

REM

A

beta
25%
dreaming, loss of motor tone, brain increases O2 use

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64
Q

ventral postero-medial nucleus of thalamus

A

trigeminal and gustatory path

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65
Q

ventral posterio-lateral nucleus of thalamus

A

spinothalamic and dorsal/medial lemniscus

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66
Q

lateral geniculate nucleus

A

optic nerve

calcarine sulcus

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67
Q

medial geniculate nucleus

A

superior olive and inferior coliculus of tectum

hearing

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68
Q

ventral lateral nucleus

A

basal ganglia, cerebellum

motor

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69
Q

what is the function of the limbic system?

A

emotion, long-term memory, olfaction, behaviour modulation, ANS function
The 5Fs - Feeding, fleeing, fighting, feeling, fornication (sex)

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70
Q

what is in the limbic system?

A

hippocampus, amygdala, fornix, mammillary bodies, cingulate gyrus

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71
Q

Dopaminergic pathways which decrease activity

A

mesocortical, nigrostriatal, tuberinfundibular

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72
Q

dopaminergic pathway increasing activity

A

mesolimbic

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73
Q

tuberoinfundibular area

A

libido, sexual dysfunction, galactorrhea, gynecomastia

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74
Q

mesolimbic area

A

delusion, hallucination

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75
Q

mesocortical area

A

flat effect

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76
Q

cerebellar input

A

middle cerebellar peduncle from contralateral cortex

ipsilateral proprioceptive information via inferior peduncle

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77
Q

output of cerebellum

A

superior cerebellar peduncle

contralateral cortex

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78
Q

nuclei of cerebellum (lateral to medial)

A

dentate, emboliform, globose, fastigial

Don’t Eat Greasy Foods

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79
Q

lateral cerebellar lesions

A

voluntary movement of extremities

ipsilateral

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80
Q

medial cerebellar lesions

A

midline structures, bilateral motor deficits

axial and proximal limb

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81
Q 
function of basal ganglia
stimulation
A

voluntary movement, postural adjustment

cortex

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82
Q

striatum

A

putamen (motor) + caudate (cognitive)

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83
Q

lentiform

A

putamen (motor) + globus ballidus

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84
Q

excitation of basal ganglia

A

cortex –> striatum –> GABA –> inhibits Globus pallidus internus GABA –> disinhibits thalamus via the globus pallidus interna

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85
Q

inhibition of basal ganglia

A

cortex –> striatum –> GABA –> stops subthalamic nucleus via globus pallidus externa inhibition –> subthalamic nucleus stimulates globus pallidus interna to inhibit thalamus

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86
Q

DA on the basal ganglia

A

stimulates excitatory (D1) and inhibits inhibitory (D2)

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87
Q

athetosis is

seen in

A

slow writhing movements - snake like

Huntingdon’s

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88
Q

chorea comes from

A

basal ganglia

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89
Q

dystonia

A

sustained involuntary muscle contraction

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90
Q

hemibalismus

A

may be +- ipsilateral leg

contralateral subthalamic nucleus

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91
Q

myoclonus example

A

jerks, hiccups

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92
Q

a-synuclein

A

lewy bodies

parkinson’s

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93
Q

NMDA-R binding, glutamate excitotoxicity

A

Huntingdon’s

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94
Q

what atrophies in huntingdon’s?

A

caudate and putamen

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95
Q

Broca area

part damaged

A

frontal lobe

speech

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96
Q

wernicke’s area

part damaged

A

temporal lobe

comprehension

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97
Q

conduction aphasia

A

can’t repeat

arcuate fasiculus

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98
Q

global aphasia

A

everything impaired

arcuate fasciculus, broca and wenicke

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99
Q

transcortical motor aphasia

A

can’t speak

area around broca

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100
Q

transcortical sensory aphasia

A

can’t comprehend

area around Wernicke

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101
Q

transcortical mixed aphasia

A

trouble speaking and comprehending

areas around structures damaged, structures themselves okay

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102
Q

Kulver-Bucy syndrome
causes
affecs
associated with

A

disinhibited behaviour
amygdala
HSV-1 encephalitis

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103
Q

frontal lobe lesion

A

disinhibition, deficits in concentration, orientation, judgement
primitive reflexes may reemerge

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104
Q

nondominant parietal cortex

A

hemispatial neglect syndrome

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105
Q

dominant parietal cortex

A

agraphia, acalculia, finger angosia, left-right disorientation

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106
Q

Gerstmann syndrome

A

dominant parietal cortex damage

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107
Q

damage to reticular activating system

A

reduced arousal and wakefluness - coma

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108
Q

wernicke-korsakoff syndrome affects

A

mammillary bodies

B1

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109
Q

basal ganglia damage

A

tremor at rest, chorea, athetosis

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110
Q

subthalamic nucleus damage

A

contralateral hemiballism

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111
Q

hippocampal damage

A

anterograde amnesia

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112
Q

paramedian pontine reticular formation

A

eyes look away from lesion

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113
Q

frontal eye field damage

A

eyes look to lesion

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114
Q

what does cerebral perfusion rely on?

A

a pressure gradient between MAP and ICP

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115
Q

theraputic hyperventilation

use

A

decreases CO2, vaoconstriction, decreasing cerebral blood flow and decreasing ICP
cerebral edema

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116
Q

When does hypoxemia increase CPP?

A

<50 mmHg

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117
Q

lacunar infarct from htn

A

lenticulo-striate artery

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118
Q

contralateral paralysis+-sensory, absense of cortical signs

A

lenticulo-striate artery

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119
Q

lower limb stroke signs

A

anterior cerebral artery

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120
Q

upper limb stroke signs with aphasia/hemineglect

A

middle cerebral artery

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121
Q

contralateral paralysis of upper and lower, proprioception decreased, tongue deviates ipsilaterally

A

anterior spinal artery

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122
Q

medial medullary syndrome

A

infect to paramedian branches of ASA and or vertebral arteries

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123
Q

anterior spinal artery supplies

A

lateral corticospinal, medial lemniscus, caudal medulla (hypoglossus)

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124
Q

hoarse, dysphagia, vertigo, decreased facial pain and temperature sensation ipsilateral, body contralateral, horner syndrome

A

posterior inferior cerebellar artery

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125
Q

facial paralysis, vertigo, no taste in anterior 2/3 of tongue

A

anterior inferior cerebellar artery

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126
Q

vertical eye movement, quadraplegia, counscious

A

basilar artery stroke

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127
Q

hemianopia with macular sparing

A

posterior cerebral artery

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128
Q

Charcot-Bouchard microaneurysm

A

chronic htn

affects small vessels which can’t be seen on angio

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129
Q

ipsilateral CN III palsy –> mydriasis

A

posterior communicating artery

blown pupil with ptosis and down and out eye

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130
Q

epidural hematoma

A

middle meningeal

lucid interval

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131
Q

biconvex on CT

A

epidural

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132
Q

subdural due to

CT

A

bridging vein rupture

crescent shape

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133
Q

intraparenchymal hemorrhage

A

can be from reperfusion injury

basal ganglia nd internal capsule

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134
Q

most vulnerable area to ischemia

A

hippocampus

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135
Q

reactive gliosis

A

1-2 weeks post ischemia

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136
Q

microglia

A

3-5 days post ischemia

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137
Q

signs of raised ICP

A

venous sinus thrombosis

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138
Q

foramen of monro

A

connects lateral and 3rd ventricles

139
Q

cerebral aqueduct of sylvius

A

connects 3rd and 4th ventricles

140
Q

4th ventricle has

A

foramine of luschka (lateral) and foramen of magendie (medial)

141
Q

what is CSF made by?

A

ependymal cells of choroid plexus

142
Q

Reabsorption of CSF

A

arachnoid granulations

143
Q

RF idiopathic ICP

A

woman, vitamin A xs, danazol, tetracycline

144
Q

communicating hydrocephalus

A

not being reabsorbed

145
Q

normal pressure hydrocephalus

triad

A

elderly from expansion of ventricles

urinary incontinance, ataxia, cognitive dysfunction (wet, wobbly, wacky)

146
Q

noncommunicating hydrocephalus

A

blockage of CSF circulation

147
Q

ex vacuo ventriculomegaly

A

looks like raised CSF but from decrease in brain tissue

148
Q

spinal cord ends

adult

A

L1-L2

149
Q

fasciculus gracilis

A

in dorsal column

for lower body and legs (medial)

150
Q

fasiculus cuneatus

A

in dorsal column

upper body, arms (lateral)

151
Q

dorsal column

A

pressure, vibration, touch, proprioception

152
Q

spinothalamic column

A

pain temperature

anterior - crude touch, pressure

153
Q

spinal column tracts organisation

A

sacral lateral

cervical medial

154
Q

dorsal column decussation

synapses

A

medulla
nucleus cutaneous/gracilis in medulla
thalamus

155
Q

spinothalamic tract decussation

synapses

A

anterior white commissure
ipsilateral grey matter
thalamus

156
Q

lateral corticospinal decussation

synapses

A

level of spinal cord
cell body of anterior horn
NMJ

157
Q

atrophy, fasiculation

A

LMN

158
Q

spastic paralysis

A

UMN

159
Q

degeneration of anterior horns
causes
diseases

A

LMN - floppy baby

poliomyelitis (asymmetric), Werdnig-Hoffmann disease (symmetric)

160
Q

UMN + LMN, no bowel/bladder issue

A

amyotrophic lateral sclerosis

161
Q

what can amyotrophic lateral sclerosis be associated with?

A

superoxide dismutase 1 defect

162
Q

asymmetric limb weakness, fasciculation, atrophy
is
Rx

A

amyotrophic lateral sclerosis

Riluzole

163
Q

Upper thoracic issue, spares dorsal column

A

complete occlusion of anterior spinal artery

164
Q

tertiary syphilis spinal cord

A

tabes dorsalis

demyelination of dorsal column/roots

165
Q

syringomyelia damages

A

anterior white commissure of spinothalamic tract

166
Q

B12 deficiency affects which areas of the spinal column?

A

Spinocerebellr tract
lateral Corticospinal
Dorsal
SCD

167
Q

Friedrich ataxia genetics

A

GAA

AR on chr.9

168
Q

Friedreich ataxia

A

kyphoscoliosis, hypertrophic cardiomyopathy, staggering gait, frequent falling, hammer toes, diabetes

169
Q

Brown-Sequard

A

ipsilateral UMN, dorsal damage

contralateral pain and temperature loss

170
Q

moro reflex

A

abduct arms when startled then draw together

171
Q

rooting reflex

A

nipple seeking

172
Q

galant reflex

A

stroking on one side of spine cause lateral flexion towards stimulated side

173
Q

which CNs are medial?

A

III, IV, VI, XII

174
Q

pineal gland

A

melatonin secretion, circadian rhythm

175
Q

superior colliculi

A

conjugate vertical gaze centre

176
Q

inferior colliculi

A

auditory

177
Q

CNs in brain strem

A

I-IX - above Pons
V-VIII - in pons
IX-XII - are in medulla

178
Q

CN nuclei

A

midbrain - III, IV
pons - V-VIII
medulla IX, X, XII
spinal cord XI

179
Q

CN V exits

A

superior orbital fissure
foramen rotundum
foramen ovale

180
Q

superior oblique

A

IV

181
Q

lateral rectus

A

VI

182
Q

dorsal motor nucleus

A

PANS fibres to heart, lung, upper GI - X

183
Q

nucleus ambiguus

A

motor to pharynx, largyn, upper esophagus

IX, X, XI

184
Q

nucleus solitarius

A

visceral sensory

VII, IX, X

185
Q

V1 reflexes

A

corneal, lacrimation

186
Q

V3 reflex

A

jaw jerk

187
Q

gag reflex

A

IX and X (Efferent)

188
Q

CN V lesions

A

jaw deviates towards

189
Q

CN X lesion

A

uvula deviates away

190
Q

CN IX lesion

A

weak turning away from lesion

shoulder drop on side of lesion

191
Q

CN XII lesion

A

tongue deviates towards LMN

192
Q

which muscle opens the jaw?

A

lateral pterygoid

193
Q

UMN face

A

contralateral

forehead sparing

194
Q

LMN face

A

ipsilateral

loss of taste

195
Q

forehead sensation lost, followed by other nerve palsies, opthalmoplegia

A

cavernous sinus syndrome

196
Q

tonotopy

A

different frequencies lead to vibration at specific locations on basilar membrane

197
Q

high frequency

low frequency

A

base of cochlea

heliocotrema

198
Q

noise enduced hearing loss

A

stereociliated cells in organ of Corti

199
Q

iris dilator and sphincter control

A

dilator - a1

sphincter - M3

200
Q

hyperopia

A

light focusses behind retina

201
Q

myopia

A

focus in front of retina

202
Q

presbyopia

A

age related impaired accommodation from decrease in lens elasticity

203
Q

RF cataract

A

age, smoking, alcohol, sunlight, GC use, DM, trauma, infection, galactosemia, GK deficiency, trisomies, ToRCHeS infections, Marfans, alport syndrome, myotonic dystrophy, NF 2

204
Q

disc cupping, peripheral vision loss

A

Glaucoma

205
Q

secondary open angle glaucoma

A

post infection blocking trabecular meshwork

206
Q

closed angle glaucoma

A

enlargement or forward movement of lens against central iris obstructing flow

207
Q

uveitis may have

A

hypopion

208
Q

anterior uveitis
intermediate
posterior

A

iritis
pars plantis
choroiditis/retinitits

209
Q

wet macular degeneraton Rx

A

anti-VEGF injection

ranibizumab

210
Q

Rx diabetic retinopathy

A

photocoagulation, surgery, anti-VEGF

211
Q

retinal detachment RF

A

myopia, trauma

212
Q

retinitis pigmentosa

A

inherited retinal degeneration

night blindness first

213
Q

bone spicule shaped deposits around macula

A

retinitis pigmentosa

214
Q

control of miosis

A

edinger-westphal nucleus –> ciliary ganglion –> pupillary sphincter

215
Q

mydriasis area

A

ciliospinal centre of Budge

216
Q

Marcus Gunn pupil

A

afferent pupillary defect - swinging light test

217
Q

Horner syndrome associated with

A

lesion aboe T1

218
Q

IV damage

A

eye moves upwards

head tilt towards lesion

219
Q

VI damage

A

eye medial

cannot abduct

220
Q

bilateral internuclear opthalmoplegia

A

MS

221
Q

medial longitudinal fasciculus

what you see

A

VI and III interplay so eyes move in the same direction

abducting eye gets nystagmus, adducting eye is impaired

222
Q

Alzheimers proteins

A

ApoE2 - protective for sporadic
Apo E4 - worse for sporadic
APP, presenilin, familial

223
Q

neurofibrillary tangles, cortical atrophy

A

alzheimer’s

224
Q

personality, behaviour and speech change first dementia

A

frontotemporal

225
Q

ubiquitinated TDP-43

A

frontotemporal dementia

226
Q

lewy body dementia

A

hallucinations, parkinsonian features

227
Q

CJD affects the

A

spongiform cortex and prions

228
Q

central pontine myelinosis (osmotic demyelination syndrome)

can cause

A

correcting Na too fast

locked in syndrome, paralysis, dysarthria, dysphagia, diplopia, LOC

229
Q

scanning speech, intention tremor, nystagmus

A

MS

230
Q

Increased IgG, myelin basic protein in CSF, oligoclonal bands

A

MS

231
Q

Rx MS spascitity

A

baclofen, GABAb R agonists

232
Q

acute inflammatory demyelinating polyradiculopathy

A

GBS

233
Q

inflammation after vaccination or infection

A

acute disseminated encephalomyelitis

234
Q

charcot-marie-tooth

A

defective protein production in peripheral nerve myelin sheath
AD

235
Q

krabbe disease

A

Lysosmal storage disease destroying myelin

236
Q

galactocerebrosidase deficiency

globoid cells

A

Krabbe disease

237
Q

AIDS encephalopathy

due to

A

progressive multifocal leukoencephalopathy

JC virus reactivation

238
Q

complex partial seizure

A

impaired consciousness

239
Q

absence seizure

A

no postictal state

240
Q

tonic seizure

A

stiff

241
Q

cluster versus tension

A

unilateral, bilateral

242
Q

mutation of GNAQ gene

A

Sturge-Weber syndrome

243
Q

Sturge-Weber characteristics

A

STURGE

Sporadic, port wine Stain, Tram track calcifications, unilateral, retardation, glaucoma, GNAQ, Epilepsy

244
Q

Tuberous sclerosis features

A

HARMATOMAS
Harmatomas, Angiofibromas, Mitral regurg, Ash-leaf spots, Rhabdomyoma of cardiac, T, ADominant, Mental retardation, angiomtolipoma (renal), Seizures, Shagreen patches

245
Q

nail fibroma, seizure, pale skin patches, arryhthmia

A

tuberous sclerosis

246
Q

NF-1 cafe au lait spots

A

in armpit and groin

247
Q

bilateral renal cell carcinoma, pheochromocytoma

A

VHL

248
Q

butterfly tumour

A

glioblastoma

249
Q

GFAP astrocytes

A

glioblastoma

250
Q

meningioma

A

benign, arachnoid cells, dural tail

251
Q

spindle cells in a whorled body with psammoma bodies

laminated calcifications

A

meningioma

252
Q

hemangioma found in which area?
associated with
can produce

A

cerebellar
VHL, retinal angioma
EPO

253
Q

vestibular schwannoma associated with

A

NF2

254
Q

chicken wire capillary pattern

A

oligodendroglioma

255
Q

vertical gaze paly tumour

A

pinealoma

256
Q

pinealoma males

A

bHCG and precocious puberty

257
Q

posterior fossa tumour, GFAP

A

pilocytic astrocytoma

258
Q

rosenthal fibres

A

eosinophilic

pilocytic astrocytoma

259
Q

medulloblastoma

can cause

A

malignant

drop mets to spinal cord

260
Q

Homer-Wright rosettes, small blue cells

A

medulloblastoma

261
Q

tumour bitemporal hemianopia and difference

A

pituitary adenoma

craniopharyngeaoma - calcification, cholesterol crystals

262
Q

cingulate herniation under falx cerebri

A

anterior cerebral compression

263
Q

transtentorial herniation

A

rupture of paramedian basilar artery branches

brain stem

264
Q

uncal herniation

A

blown pupil, ipsilateral PCA

265
Q

cerebellar tonsillar hernation

A

death from brain stem compression

266
Q

Glaucoma B blockers

A

timolol, betaxolol, carteolol

267
Q

what do a and b blockers do in the eye?

A

decrease aq humour production

268
Q

drugs not to use in closed angle glaucoma and why

A

a1 blockers

cause mydriasis

269
Q

drugs increasing outflow of aq humour from ciliary muscle contraction

A

cholinomimetics (M3)

prostaglandins

270
Q

cholinomimetic for glaucoma

A

pilocarpine, carbachol, phsostigmine, echothiophate

271
Q

long eyelashes, browning of iris

A

prostaglandins for glaucoma

272
Q

what do opioid receptors do?

A

close Ca channels, open K channels

inhibit ACh, NE, 5-HT, glutamate, substance P release

273
Q

pentazocine

careful with

A

k-opioid R agonist
u-opioid R antgonist
opiate withdrawl symptoms is taken with full opiate

274
Q

butorphanol mechanism
use
careful

A

k-opioid agonist, u-opioid partial agonist
severe pain with less respiratory depression
OD not easily reversed

275
Q

tramadol

s.e.

A

weak opioid agonist, also inhibits 5-HT and NE reuptake

decreases seizure threshold

276
Q

ethosuximide use

A

absense seizure

277
Q

Benzodiazapines use

A

status epilepticus

278
Q

Phenobarbital use

A

simple, complex, tonic-clonic

279
Q

Neonatal seizure

A

phenobarbital

280
Q

phenytoin can be used for

A

all except absense

281
Q

first line tonic-clonic

A

phenytoin

valproate

282
Q

first line prevention status epilepticus

A

phenytoin

283
Q

carbamazepine use

A

simple, complex, tonic clonic

284
Q

epilepsy drugs increasing GABA

A

benzodiazapines, phenytoin, topiramate

285
Q

epilepsy drugs inhibiting GABA transaminase

A

valproic acid, vigabatrin, levetiracetam

286
Q

epilepsy drugs inhibiting GABA reuptake

A

tigabine

287
Q

epilepsy drugs inhibiting Ca channels

A

ethosuximide, gabapentin

288
Q

epilepsy drugs inhibiting Na channels

A

phenytoin, carbamazepine, valproic acid, topiramate, lamotrigine

289
Q

valproic acid use

A

all apart from status epilepticus

290
Q

vigabatrin use

A

simple, complex

291
Q

gabapentin use

A

simple, complex

292
Q

topiramate

A

simple, complex, tonic-clonic

293
Q

lamotrigine

A

all apart from status

294
Q

levetriacetam

A

simple, partial, tonic-clonic

295
Q

tigabine

A

simple, complex

296
Q

mental dulling, kidney stones, weight loss

A

topiramate

297
Q

migrane prevention

A

topiramate

298
Q

barbituate mechanism

A

increase Cl channel opening length, decrease neuron firing

299
Q

barbituate use

A

anaesthesia induction

anxiety, seizures, insomnia

300
Q

benzodiazapine OD

A

flumazenil

301
Q

acute benzodiazapine withdrawl

A

triggers seizures

302
Q

nonbenzo hypnotics

A

zolipidem, zaleplon, eszopiclone

303
Q

BZI subtype of GABA

A

non benzo hypnotics

304
Q

MAC - minimal alveolar concentration

A

minimal alveolar concentration required to prevent 50% of subjects moving in response to noxious stimuli

305
Q

low blood solubility

A

rapid induction and recovery

306
Q

high lipid solubility

A

high potency

307
Q

potency =

A

1 / MAC

308
Q

inhaled anaesthetics cause

A

myocardial depression, resp depression, nausea, increased cerebral blood flow

309
Q

halothane issue

A

hepatotoxicity

310
Q

methoxyflurane issue

A

nephrotoxicity

311
Q

enflurane

A

proconvulsant inhaled anaesthetic

312
Q

barbituate use in anaesthesia

A

high potency, rapid BBB, induction, short procedures
redistributed to tissue and fat
decreases cerebral blood flow

313
Q

benzo anaesthetic use

s.e

A

endoscopy

post op resp depression and hOtn, anterograde amnesia

314
Q

ketamine mechanism

A

PCP analog blocks NMDA Rs

315
Q

propofol use

A

induction, short procedures, GABAa potentiator

316
Q

L.A amides

A

lidocaine, mepivacaine, bupivicaine (all have 2 Is)

317
Q

LA types

A

amide, ester

318
Q

mechanism LA

A

block na channels by binding to inner channel

319
Q

tertiary amine LA mechanism

A

penetrate membrane uncharged, then bind to ion channel when charged

320
Q

what specifically needs to be used in infected tissue for LA and why?

A

alkaline

infection is acidotic and needs to cross into the cell

321
Q

order of sesnsation loss in LA

A

pain, temperature, touch, pressure

322
Q

s.e. bupivicaine

A

CV toxicity

323
Q

s.e. benzocaine

A

methemoglobinemia

324
Q

depolarising blockers

A

succinylcholine

325
Q

reversal of depolarising block

A

can’t reverse phase I

phase II reverse with cholinesterase inhibitors

326
Q

s.e. succinylcholine in anaesthesia

A

hypercalcemia, hyperkalaemia, malignant hyperthermia

327
Q

non depolarising blockers

antidote

A

curiums

neostigmine/ cholinesterase inhibitors

328
Q

what do you give neostigmine with?

A

atropine to stop bradycardia

329
Q

dantrolene mechanism

use

A

prevents Ca release from SR, binding ryanodine R

malignant hyperthermia and neuroleptic malignant syndrome

330
Q

baclofen mechanism

use

A

activates GABAb in spinal cord relaxing skeletal muscle

muscle spasm

331
Q

cyclobenzaprine mechanism

use

A

centrally acting skeletal muscle relaxant

muscle spasm

332
Q

dopamine agoinsts

A

ergot - bromocriptine

non-ergot - pramirexole, ropinirole

333
Q

amantadine

s.e.

A

increases dopamine release and decreases reuptake

livedo reticularis

334
Q

levodopa + carbidopa

s.e.

A

crosses into brain
stops peripheral conversion to dopamine (inhibits dopa-decarboxylase)
arrhythmia from catecholamine formation

335
Q

entacapone

A

prevents peripheral L-dopa degradation by inhibiting COMT

336
Q

selegiline

A

inhibits MAO-B

337
Q

benztropine

A

antimuscarinic improving tremor and rigidity in parkinson’s

338
Q

memantine mechanism

use

A

NMDA R antagnoist

alzheimer’s

339
Q

donepezil, galantamine, rivastigmine, tacrine mechanism

use

A

AChE inhibitors

Alzheimer’s

340
Q

tetrabenazine, reserpine mechanism

use

A

inhibit vesicular monoamine transporter (VMAT) decreasing DA release
Huntingdon’s

341
Q

Riluzole does

use

A

decreases glutamate excitotoxicity

ALS

342
Q

Triptans mechanism

use

A

5-HT agonists

migrane, cluster headaches

343
Q

triptan s.e.

A

coronary vasospasm

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