Set 11 (CNS and Endocrine) Flashcards by Ruby Chang

Tremor
Worsens while particular posture is being maintained
Improve w/ alcohol consumption

Essential tremor

How well did you know this?

Not at all

Perfectly

DOC for essential tremor

Propranolol

How well did you know this?

Not at all

Perfectly

Benztropine

Anticholinergic

Tx: PD, counteract neuroleptic drug extrapyramidal A/E

How well did you know this?

Not at all

Perfectly

Clozapine

Atypical antipsychotic (block 5HT2 receptor)

How well did you know this?

Not at all

Perfectly

C peptide

Formed from proinsulin in Golgi
Packaged along w/ insulin in secretory granules
Secreted together w/ insulin

How well did you know this?

Not at all

Perfectly

Inhibit NTms reuptake in adrenergic synapses

Cocaine

TCA

How well did you know this?

Not at all

Perfectly

Mucosal atrophy, partial septum destruction

Cocaine abuse

How well did you know this?

Not at all

Perfectly

Reserpine

Block NT entry into presynaptic vesicles

How well did you know this?

Not at all

Perfectly

Agitation
Dramatic symmetric pupillary DILATION that remains RESPONSIVE to light
Tachycardia
Increased BP

Cocaine intoxication

How well did you know this?

Not at all

Perfectly

Allow patients to serve as their own control

x-over trials

How well did you know this?

Not at all

Perfectly

HYPOgonadism
Eunuchoid habitus
Small firm testis

Klinefelter (47, XXY)

How well did you know this?

Not at all

Perfectly

LH normal
FSH elevated
Testosterone normal, low sperm count

Cryptorchidism

seminiferous tubule damaged, leydig cell preserved

How well did you know this?

Not at all

Perfectly

Carpal tunnel syndrome is a/w?

Hypothryoidism
DM
RA
Dialysis-associated amyloidosis

How well did you know this?

Not at all

Perfectly

Responsible for many of the toxic effects observed in meningitis and meningococcemia?

Meningococcal lipo-oligosaccharide (LOS)

How well did you know this?

Not at all

Perfectly

Hirsutism: tx

Spironolactone (Aldo receptor antagonist)
Flutamide (inhibit testosterone binding to receptor)
Finasteride (5-alpha reductase inhibitor)

How well did you know this?

Not at all

Perfectly

Clomiphene

Anti-estrogen for tx of infertility

inhibit negative feedback of estrogen on CNS –> increasing synthesis of GnRH –> gonadotrophins

How well did you know this?

Not at all

Perfectly

m/c finding of PCA stroke

CONTRAlateral homonymous hemianopia w/ macula sparing

How well did you know this?

Not at all

Perfectly

Thyroid peroxidase responsible for?

Oxidation of inorganic iodine
Formation of mono/di-iodotyrosine
Coupling tha tforms T3 and T4

How well did you know this?

Not at all

Perfectly

Morphine: MOA

Binds mu receptor –> GPCR –> activation of K+ conductance, inhibition of Ca2+ conductance, inhibition of AC, inhibition of NT release

How well did you know this?

Not at all

Perfectly

High GH

Low IGF-1

Larson dwarfism

How well did you know this?

Not at all

Perfectly

GH acts through what pathway?

JAK-STAT pathway

How well did you know this?

Not at all

Perfectly

Loss of gag reflex (afferent limb)

Glossopharyngeal n.

How well did you know this?

Not at all

Perfectly

Loss of sensation in:
Upper pharynx, posterior tongue, tonsils
Middle ear cavity
Loss of taste form posterior 1/3

Glossopharyngeal n. lesion

How well did you know this?

Not at all

Perfectly

Fixed segmental loss of UE pain and temperature
UE LMN signs
LE UMN signs
Scoliosis

Syringomyelia

How well did you know this?

Not at all

Perfectly

Botulism toxin

Prevent release of acetylcholine from nerve terminals in NMJ (--> flaccid paralysis)

Diplopia Dysphagia Dysphonia w/i 12-46hrs of consumption of food

Botulinum

Typical HIGH potency anti-psychotics

``` MORE likely to cause extrapyramidal sx LESS likely to cause anticholinergic/antihistamine A/E Haloperidol Fluphenazine Pimozide ```

Typical LOW potency anti-psychotics

Chlorpromazine | Thioridazine

Atypical antipsychotics

Clozapine Risperidone Olanzapine Quetiapine

Neonate: Pupillary dilatation Rhinorrhea, sneezing, nasal stuffiness Diarrhea, N, V

Acute neonatal narcotic withdrawal | Tx: diluted tincture of opium

Flumazenil

Benzo receptor ANTAGONIST | for: benzo reversal

Naloxone

PURE opioid receptor ANTAgonist

Ketamine

NMDA receptor blocker

Morphine tolerance: MOA

Activation of NMDA receptors of glutamate (Increased phosphorylation of opioid receptors, Increased NO levels) Increased AC activity

Organophosphates stimulate?

BOTH muscarinic and nicotinic receptors

the ONLY med that reverses BOTH muscarinic and nicotinic effects of organophosphate?

Pralidoxime | regenerate cholinesterate

Somatostatinomas

HYPERglycemia OR HYPOglycemia Steatorrhea Gallbladder stones

Pentazocine

Partial agonist AND weak antagonist at mu receptor (analgesia w/o abuse potential) (do NOT combine w/ morphine: withdrawal sx)

Ptosis and "down and out" gaze | Light reflex normal

CN III neuropathy

Lacunar strokes manifest w?

Pure motor or Pure sensory

Most sedating 1st gen H1 receptor blockers

Dephenyhydramine Promethazine Hydroxyzine Chlorpheniramine

Loratadine

2nd gen antihistamine (blocks PERIPHERAL H1 histamine receptors)

Chlorthalidone

Thiazide diuretic

Exclusively ketogenic a.a. (would NOT increase blood lactate in patients w/ Pyruvate dehydrogenase deficiency)

Lysine (essential a.a) | Leucine

Neisseria meningitidis: route of colonization

Pharynx --> Blood --> Choroid plexus --> Meninges

H. influenzae: route of colonization

Pharynx --> Lymphatics --> Meninges

Decrease blood sugar by activation of PPAR gamma

Thiazolidinediones (TZDs)

Insulin receptor

Tyrosine kinase

Leads to insulin resistance (cell biology)

Aberrent serine and threonine residue phosphorylation | TNF-alpha, catecholamines, glucocorticoids, glucagon

Phenytoin toxicity

Cerebellum/vestibular system: ataxia, nystagmus Gingival hyperplasia (via PDGF) Megaloblastic anemia Induce CYP450 Fetal hydrantoin syndrome (pregnant women)

Phenytoin: MOA

Block VG-Na+ channel

Lithium: A/E

NMJ excitability Nephrogenic DI Hypothyroidism Cardiac conduction defects

Clozapine: A/E | (Atypical antipsychotic for negative sx0

Agranulocytosis | Seizures

Failure of GnRH secreting neurons to migrate from OLFACTORY lobes to hypothalamus

Kallman's syndrome

Parafollicular C-cells: embryological origin

Ultimobranchial bodies

Drug induced parkinsonism: DOC

Benztropine Amantadine (Levodopa and dopamine agonist are CONTRAINDICATED in antipsychotic-induced parkinsonism)

Drug induced Parkinsonism is caused by?

D2 receptor blockage in Nigrostriatal pathway

Anticholinergics should be avoided in?

Elderly patients: esp w/: BPH Angle-closure glaucoma

Schizophreniform

Psychotic sx that interfere w/ patient's functional status for 1-6months (>6= schizophrenia) (<1 = brief psychotic disorder)

Fragile X is caused by?

Increased # of CGG repeats --> hypermethylation of FMR1 gene --> gene inactivation

Chromosome instability disorders

``` Xeroderma pigmentosum Ataxia-telangeictasia Fanconi's anemia Bloom syndrome (defects in DNA repair enzymes) ```

Utilize tyrosine kinase-associated receptors and JAK/STAT pathway

Colony stimulating factors Prolactin Growth hormones Cytokines

Receptor tyrosine kinase + MAP kinase pathway

Growth factor receptors (EGF, PDGF, FGF, Insulin)

Flutamide

Non-steroid anti-androgen (compete w/ testosterone and DHT for testosterone receptors) (use combined w/ GnRH agonists)

Anti-Yo Anti-P/Q Anti-Hu

Paraneoplastic cerebellar degeneration antibodies

``` Rapidly progressive dementia and myoclonic jerks Spongiform encephalopathy (vacuoles in gray matter) ```

Creutzfeldt-Jakob disease (prion)

Cerebellar ataxia Telangiectasias Increased risk of sinopulmonary infections (IgA deficiency)

``` Ataxia telangiectasias (AR, ATM gene in DNA break repair) ```

Lesch-Nyhan syndrome

X-linked recessive | HGPRT defect: defective purine catabolism

Severe hyperuricemia/gout, mental retardation, choreoathetoid movements, spasticity, self mutilating behavior

Lesch-Nyhan syndrome | X-linked recessive, HGPRT defect