Summative #3 Memorization, Week 8

Question 1

Frontotemporal lobar degenerations

Answer 1

Heterogeneous group of non-AD dementias that preferentially affects frontal and temporal lobes. Pick’s disease falls in this category. Deterioration in social function and personality.

Question 2

Dementia with Lewy Bodies

Answer 2

Like Parkinson’s but Lewy bodies have less defined “halo” and are found in cortical regions. Consider with Parkinsonian motor symptoms with early Alzheimer’s-like deficits

Question 3

Focal seizures

Answer 3

Simple focal: still conscious, aura common, may experience motor, sensory, autonomic, or psychic signs

Complex focal: impaired consciousness (complete or mild), may experience automatisms, may or may not be preceded by aura

Question 4

Midbrain blood supply

Answer 4

PCA = lateral and medial

Question 5

Pons blood supply

Answer 5

AICA = lateral
Basilar = medial

Question 6

Medulla blood supply

Answer 6

PICA = lateral
ASA = medial

Question 7

Nucleus ambiguous

Answer 7

Speech, gag, uvula elevation

Question 8

Solitary nucleus

Answer 8

Taste and sensation in the mouth

Question 9

Anterior and posterior hypothalamus and temperature regulation

Answer 9

Anterior - temperature sensation and initiation of heat reduction mechanisms

Posterior - initiation of heat production mechanisms

Question 10

Lateral vs ventromedial hypothalamic nuclei

Answer 10

Lateral = feeding/hunger
Ventromedial = satiety

Question 11

Leptin

Answer 11

Released by adipocytes to induce satiety

Question 12

Ghrelin, orexin, and melanin-concentrating hormone

Answer 12

Stimulate feeding behavior

Question 13

Efavirenz

Answer 13

Non-nucleoside antiretroviral associated with worsening mood symptoms including depression, mania, and suicidality. Exacerbates PTSD symptoms.

Question 14

Issue with protease inhibitor therapy for HIV

Answer 14

Inhibit part of cytochrome p450 complex which means it has a lot of drug interactions

Question 15

Scopolamine

Answer 15

Muscarinic receptor antagonist, administered via transdermal patch, especially for motion sickness

Question 16

Olanzapine

Answer 16

Targets dopaminergic, serotonergic, muscarinic, histaminergic and adrenergic receptors, good when other medications won’t work

Question 17

Promethazine

Answer 17

H1 antagonist and weak DA antagonist, used for pregnancy, can be in form of suppository

Question 18

Brain regions dysfunctional in a coma

Answer 18

Bilateral pontomesenphalic reticular formation (midbrain area)
Bilateral diffuse regions of cortex
Bilateral thalami

Question 19

Small responsive pupils bilaterally

Answer 19

Pontine lesion

Question 20

Bilateral pinpoint pupils

Answer 20

Opiate overdose

Question 21

Central taste pathway

Answer 21

Geniculate ganglion > nucleus of the solitary tract > VPM thalamus > primary cortical taste area

Question 22

CNS malformation trisomies

Answer 22

21 = Down
13 = Patau
18 = Edward

Question 23

Fragile X syndrome

Answer 23

CGG or GCC repeat at FMR gene on X chromosome

Lower posterior fossa microcephaly, hypertrophy of caudate nucleus and other subcortical nuclei, abnormal dendritic geometry, heterotopias

Question 24

Ethosuximide

Answer 24

Inhibition of t-type calcium channels

Only used for purse absence seizures

Question 25

Phenytoin

Answer 25

Stabilize Na+ inactivation gate prolonging absolute refractory period Declining use because and pharmacokinetics

Question 26

Carbamazepine/Oxcarbamazepine

Answer 26

Stabilize Na+ inactivation gate prolonging absolute refractory period Well tolerate with few side effects, may worsen absence seizures, risk of hyponatremia

Question 27

Lamotragine

Answer 27

Stabilize Na+ inactivation gate prolonging absolute refractory period First line for focal/partial seizures Least teratogenic

Question 28

Topiramate

Answer 28

Blacks subtype of glutamate receptors/AMPA Dose related toxicity, need to stay hydrated Broad spectrum of action, also used for migraine prophylaxis

Question 29

Valproic acid

Answer 29

Mechanism uncertain but helps inhibit high frequency firing of APs Broad specter, first line for generalized seizures Most teratogenic

Question 30

Levetiracetam

Answer 30

Binds pre-synaptic vesicular proteins, modulating synaptic transmission Indicated for partial seizures but can work for generalized, great pharmacokinetics

Question 31

AEDs for stabilization of acute manic/mixed episodes

Answer 31

Carbamazepine | Valproic acid

Question 32

AEDs for maintenance treatment of manic/mixed episodes

Answer 32

Lamotrigine Carbamazepine Valproate

Question 33

AED most effective in treating bipolar depression

Answer 33

Lamotrigine

Question 34

AEDs for diabetic neuropathy

Answer 34

Carbamazepine Lamotrigine Pregabalin Gabapentin

Question 35

AEDs for post-herpetic neuralgia and fibromyalgia

Answer 35

Gabapentin | Pregabalin

Question 36

AEDs for HIV neuropathy

Answer 36

Gabapentin

Question 37

AEDs for trigeminal neuralgia

Answer 37

Carbamazepine | Lamotrigine

Question 38

Cause of locked-in state

Answer 38

Basilar artery infarct (medial pons)

Question 39

Tests for diagnosing brain death

Answer 39

Caloric test → testing for VOR brainstem reflex Apnea test → “lack of spontaneous respirations without the ventilator