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Patho Summer 2 > Patho Summer 2 > Flashcards

Patho Summer 2 Flashcards

1
Q

Inclusion Bodies

A

Saccular structures with debris that interrupt cell function

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2
Q

What makes up the striatum?

A

Caudate and Putamen

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3
Q

What is age of onset of Parkinsons?

A

> 40 years of age. <5% are less than 40 years usually due to a secondary cause or familial and progresses fast.

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4
Q

What can cause secondary Parkinsonism?

A

Dopamine Anatgonists.
Illicit drugs
Multi-infarction in substantia nigra
Post encephalitis

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5
Q

MPTP

A

Isomeric form of Demrol. If taken by IV, will accumulate in substantia nigra, degenerating this part of brain completely causing end stage Parkinson’s within a few weeks.

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6
Q

Paraquat

A

Pesticide that triggers degeneration of substantia nigra

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7
Q

Dieldrin

A

Pesticide that triggers degeneration of substantia nigra

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8
Q

What is protective for Parkinsons?

A

Nicotine, anti-inflammatory meds, and alpha synuclein

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9
Q

What is gold standard of diagnosis of Parkinson’s?

A

Neuropathology - can show depigmentation of substantia nigra, neuronal loss and lewy bodies on autopsy

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10
Q

Clinical Manifestations of Parkinson’s

A

At least two of the following: resting tremor, rigidity, akinesia, postural instability

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11
Q

Cogwheeling

A

Resistance to passive movement

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12
Q

Festinant Gait

A

Hurried steps to avoid overbalancing, chin over heels

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13
Q

What autonomic manifestations are found in Parkinsons?

A

Orthostatic hypotension, urine retention, and seborrhea

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14
Q

What psychological disorders are common with Parkinsons?

A

Depression, Anxiety, Dementia

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15
Q

Physical Findings of Parkinsons

A

Lack of convergence, glabellar tap, blepharoclonus, head drop

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16
Q

Glabellar tap

A

exagerrated blink

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17
Q

Blepharoclonus

A

push eyelids down, will flutter

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18
Q

Wilson’s Disease

A

CNS deposits of substantia nigra can present like Parkinson’s

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19
Q

Kayer-Fleisher Ring

A

Copper deposits in iris

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20
Q

Stage 1 Parkinson

A

unilateral involvement, mild functional impairment

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21
Q

Stage 2 Parkinson

A

bilateral involvement

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22
Q

Stage 3 Parkinson

A

postural unsteadiness, not incapacitating

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23
Q

Stage 4 Parkinson

A

movement disabling, rigid bradykinesia

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24
Q

Stage 5 Parkinson

A

confined to bed, cachetic, wheelchair, constant care

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25
Q

Selegiline (Eldepryl)

A

MAO-B Inhibitor, prevents dopamine breakdown by decreasing availability of MAO

26
Q

Tasmar (Tolcapine)

A

COMT Inhibitor, prevents dopamine breakdown by decreasing availability of COMT, can have hepotoxicity

27
Q

Cogentin (Benzotropine)

A

Anti-Cholinergic, blocks cholinergic in striatum

28
Q

Artane

A

Anti-Cholinergic, blocks cholinergic in straitum

29
Q

Parlodel (Bromocriptine)

A

Dopamine Agonist

30
Q

Permax

A

Dopamine Agonist, off market because increased vascular disease

31
Q

Amantadine

A

Dopamine re-uptake inhibitor allows neurons left to keep dopamine

32
Q

What are SE of dopamine agonists?

A

Psychosis and hallucinations like schizophrenia from too much dopamine

33
Q

Can you give dopamine orally?

A

No because it does not cross BBB but L-dopa does

34
Q

Sinemet

A

L-Dopa and Carbidope, enzyme converts L-dopa in periphery so give carbidopa to block this enzyme to increase half life and get more L-dopa to the brain

35
Q

What are SE of Sinemet?

A

Dyskinesia, N/V

36
Q

Dyskinesia

A

unwanted movement

37
Q

On-Off phenomena

A

Protein competes for absorption so take on an empty stomach

38
Q

What drugs should you use for >60?

A

Use Sinement with DA Agonist.

Avoid Selegiline, Amantadine, and Anti-cholinergic (delirium)

39
Q

What drugs should use for 50-59?

A

Use Selegine, DA agonist and can add Sinemet and Amantadine.

40
Q

What drugs should use for <50?

A

Use Selegine, Amantadine and anti-cholinergics

41
Q

What are risks of palliodotomy?

A

Too far down can hit optic tract and too medial internal capsule causing sensory issues and contralateral paralysis

42
Q

How should you perform thalmotomy?

A

Only unilateral because bilateral causes dysarthria

43
Q

Thalamic Stimulation

A

Bilateral and reversible

44
Q

Schizophrenia

A

Collection of illnesses characterized by thought disorders, not interacting with environment, and talking to themselves

45
Q

What are risk factors for schizophrenia?

A

Urban area, immigration, obsterical complications, late winter-early spring birth (influenza virus exposure during neural development), advanced paternal age at time of conception

46
Q

What co-occurring conditions with schizophrenia?

A

Depression, Anxiety, alcohol abuse, substance abuse

47
Q

Positive Symptoms

A

Hallucinations, Delusions, Disorganization

48
Q

Negative Symptoms

A

Affective disorder, alogia, apathy, asociality/anhedonia

49
Q

Anhedonia

A

failure to engage with peers, little interest in sex, no intimacy

50
Q

Alogia

A

poverty of speech, thought blocking, latency of response

51
Q

Cognitive Manifestations of Schizophrenia

A

Deficits in processing, verbal learning, and memory, visual learning and memory, verbal comprehension, mood and anxiety

52
Q

Neurological Manifestations of Schizophrenia

A

Sensory integration, motor coordination and sequencing, right-left confusion

53
Q

Cataonia

A

“freezing-like state” to anything verbally and physically, hallmark is no response

54
Q

Xyprexa

A

medication that increases risk of DM, hyperlipidemia, and HTN, causes weight gain of 25 pounds per year

55
Q

How long must you have symptoms to be dx with schizophrenia?

A

6 months including build up and down of symptoms

56
Q

What neuroanatomic alterations can occur with schizo?

A

Enlargement of lateral and 3rd ventricles, widening of frontal cortical fissure and sulci. Increase rate of gray matter loss.

57
Q

Ketamine

A

Dissociative anesthetic, not used in elderly because causes hallucinations and delusions

58
Q

Haldol

A

anti-psychotic

59
Q

Chlorpromazine

A

anti-psychotic

60
Q

Locus ceruleus

A

Found in midbrain, sends out adrenergic neurons that release NE for modulatory that can affect mood, cognitive, and sensory interpretation

Patho Summer 2 (1 decks)

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