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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
Selegiline (Eldepryl)
MAO-B Inhibitor, prevents dopamine breakdown by decreasing availability of MAO
26
Tasmar (Tolcapine)
COMT Inhibitor, prevents dopamine breakdown by decreasing availability of COMT, can have hepotoxicity
27
Cogentin (Benzotropine)
Anti-Cholinergic, blocks cholinergic in striatum
28
Artane
Anti-Cholinergic, blocks cholinergic in straitum
29
Parlodel (Bromocriptine)
Dopamine Agonist
30
Permax
Dopamine Agonist, off market because increased vascular disease
31
Amantadine
Dopamine re-uptake inhibitor allows neurons left to keep dopamine
32
What are SE of dopamine agonists?
Psychosis and hallucinations like schizophrenia from too much dopamine
33
Can you give dopamine orally?
No because it does not cross BBB but L-dopa does
34
Sinemet
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
What are SE of Sinemet?
Dyskinesia, N/V
36
Dyskinesia
unwanted movement
37
On-Off phenomena
Protein competes for absorption so take on an empty stomach
38
What drugs should you use for >60?
Use Sinement with DA Agonist. | Avoid Selegiline, Amantadine, and Anti-cholinergic (delirium)
39
What drugs should use for 50-59?
Use Selegine, DA agonist and can add Sinemet and Amantadine.
40
What drugs should use for <50?
Use Selegine, Amantadine and anti-cholinergics
41
What are risks of palliodotomy?
Too far down can hit optic tract and too medial internal capsule causing sensory issues and contralateral paralysis
42
How should you perform thalmotomy?
Only unilateral because bilateral causes dysarthria
43
Thalamic Stimulation
Bilateral and reversible
44
Schizophrenia
Collection of illnesses characterized by thought disorders, not interacting with environment, and talking to themselves
45
What are risk factors for schizophrenia?
Urban area, immigration, obsterical complications, late winter-early spring birth (influenza virus exposure during neural development), advanced paternal age at time of conception
46
What co-occurring conditions with schizophrenia?
Depression, Anxiety, alcohol abuse, substance abuse
47
Positive Symptoms
Hallucinations, Delusions, Disorganization
48
Negative Symptoms
Affective disorder, alogia, apathy, asociality/anhedonia
49
Anhedonia
failure to engage with peers, little interest in sex, no intimacy
50
Alogia
poverty of speech, thought blocking, latency of response
51
Cognitive Manifestations of Schizophrenia
Deficits in processing, verbal learning, and memory, visual learning and memory, verbal comprehension, mood and anxiety
52
Neurological Manifestations of Schizophrenia
Sensory integration, motor coordination and sequencing, right-left confusion
53
Cataonia
"freezing-like state" to anything verbally and physically, hallmark is no response
54
Xyprexa
medication that increases risk of DM, hyperlipidemia, and HTN, causes weight gain of 25 pounds per year
55
How long must you have symptoms to be dx with schizophrenia?
6 months including build up and down of symptoms
56
What neuroanatomic alterations can occur with schizo?
Enlargement of lateral and 3rd ventricles, widening of frontal cortical fissure and sulci. Increase rate of gray matter loss.
57
Ketamine
Dissociative anesthetic, not used in elderly because causes hallucinations and delusions
58
Haldol
anti-psychotic
59
Chlorpromazine
anti-psychotic
60
Locus ceruleus
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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