Summative #3 Memorization, Week 8 Flashcards
Frontotemporal lobar degenerations
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.
Dementia with Lewy Bodies
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
Focal seizures
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
Midbrain blood supply
PCA = lateral and medial
Pons blood supply
AICA = lateral Basilar = medial
Medulla blood supply
PICA = lateral ASA = medial
Nucleus ambiguous
Speech, gag, uvula elevation
Solitary nucleus
Taste and sensation in the mouth
Anterior and posterior hypothalamus and temperature regulation
Anterior - temperature sensation and initiation of heat reduction mechanisms
Posterior - initiation of heat production mechanisms
Lateral vs ventromedial hypothalamic nuclei
Lateral = feeding/hunger Ventromedial = satiety
Leptin
Released by adipocytes to induce satiety
Ghrelin, orexin, and melanin-concentrating hormone
Stimulate feeding behavior
Efavirenz
Non-nucleoside antiretroviral associated with worsening mood symptoms including depression, mania, and suicidality. Exacerbates PTSD symptoms.
Issue with protease inhibitor therapy for HIV
Inhibit part of cytochrome p450 complex which means it has a lot of drug interactions
Scopolamine
Muscarinic receptor antagonist, administered via transdermal patch, especially for motion sickness
Olanzapine
Targets dopaminergic, serotonergic, muscarinic, histaminergic and adrenergic receptors, good when other medications won’t work
Promethazine
H1 antagonist and weak DA antagonist, used for pregnancy, can be in form of suppository
Brain regions dysfunctional in a coma
Bilateral pontomesenphalic reticular formation (midbrain area)
Bilateral diffuse regions of cortex
Bilateral thalami
Small responsive pupils bilaterally
Pontine lesion
Bilateral pinpoint pupils
Opiate overdose
Central taste pathway
Geniculate ganglion > nucleus of the solitary tract > VPM thalamus > primary cortical taste area
CNS malformation trisomies
21 = Down 13 = Patau 18 = Edward
Fragile X syndrome
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
Ethosuximide
Inhibition of t-type calcium channels
Only used for purse absence seizures
Phenytoin
Stabilize Na+ inactivation gate prolonging absolute refractory period
Declining use because and pharmacokinetics
Carbamazepine/Oxcarbamazepine
Stabilize Na+ inactivation gate prolonging absolute refractory period
Well tolerate with few side effects, may worsen absence seizures, risk of hyponatremia
Lamotragine
Stabilize Na+ inactivation gate prolonging absolute refractory period
First line for focal/partial seizures
Least teratogenic
Topiramate
Blacks subtype of glutamate receptors/AMPA
Dose related toxicity, need to stay hydrated
Broad spectrum of action, also used for migraine prophylaxis
Valproic acid
Mechanism uncertain but helps inhibit high frequency firing of APs
Broad specter, first line for generalized seizures
Most teratogenic
Levetiracetam
Binds pre-synaptic vesicular proteins, modulating synaptic transmission
Indicated for partial seizures but can work for generalized, great pharmacokinetics
AEDs for stabilization of acute manic/mixed episodes
Carbamazepine
Valproic acid
AEDs for maintenance treatment of manic/mixed episodes
Lamotrigine
Carbamazepine
Valproate
AED most effective in treating bipolar depression
Lamotrigine
AEDs for diabetic neuropathy
Carbamazepine
Lamotrigine
Pregabalin
Gabapentin
AEDs for post-herpetic neuralgia and fibromyalgia
Gabapentin
Pregabalin
AEDs for HIV neuropathy
Gabapentin
AEDs for trigeminal neuralgia
Carbamazepine
Lamotrigine
Cause of locked-in state
Basilar artery infarct (medial pons)
Tests for diagnosing brain death
Caloric test → testing for VOR brainstem reflex
Apnea test → “lack of spontaneous respirations without the ventilator