Week 3

Question 1

what is sleep phenomenology

Answer 1

newborns sleeping 2-4 hours equally distributed (multiphasic)

Question 2

What age can infants resettle themselves back to sleep

Answer 2

3 months

Question 3

3rd of walking time spent on

Answer 3

breastfeeding

Question 4

Biological regulation: crying

Answer 4

Normal adaptation process
• 40% of fussing and crying is inconsolable
• Decreases after 3 months and becomes
instrumental (i.e. reinforced by attention)
• No impact on later behavioural problems

Question 5

Biological regulation:Sleeping

Answer 5

• Basic sleep organization by 6 months as adults
• Most babies can sleep > 6 hours in one piece
by 6 months at night
• Self-soothing develops in the first months (if
allowed)

Question 6

Biological regulation:Feeding

Answer 6

• Infants double their weight in the first 3-6 months; treble
it by 12 months
• They need to feed frequently, also at night in the first 3
months
• Solids introduced 3-6 months*
• Sensitive window for solids (salt preference 4-8 months)

Question 7

let down reflex explain

Answer 7

The let-down reflex is what makes breastmilk flow. When your baby sucks at the breast, tiny nerves are stimulated. This causes two hormones – prolactin and oxytocin – to be released into your bloodstream. Prolactin helps make the milk, while oxytocin causes the breast to push out the milk.

Question 8

what are RP’s associated with

Answer 8

increased emotional and attanetion problems in childhood

Question 9

what is mode network

Answer 9

this mediates between RPs and anxious avoidant personality

Question 10

Early MRPS are associated with what

Answer 10

directly and indirectly associated with adolescent depression

Question 11

what are the effects of clock distribution

Answer 11

circadian rhytmn disruptions
mental health 
cardiovascular disorders
reproductive effects
brain effects
Gastrointestinal disorders
Increased Cancers

Question 12

Determinants of Pharmacokinetics

Answer 12

Absorption : drug to blood circulation
Distribution: transport of drug from intravascular to extravascular space
Metabolism: chemical transformation
Excretion

Question 13

What happens in Phase 1 and phase 2 catabolic reactions

Answer 13

Lipophilic compound is turned into water soluble excretion product

Question 14

Health benefits of chronotherapy

Answer 14

might help bipolar
seasonal mood disorder
and major depression

Question 15

effects of sleep depriavation

Answer 15

impaired immune system 
cognitive impairment
hallucinations
Risk of diabetes 
Decreased reaction time and accuracy 
Increased heart rate variability
decreased temperature

Question 16

what does obesity lead to

Answer 16

change in an individuals metabolic profile

accumulation of adipose tissue

Question 17

Master clock located in the brain does what

Answer 17

consists of 20,000 nerve cells

Question 18

suprachiasmatic nucleus (SCN)

Answer 18

controls the production of the hormone melatonin, which makes you sleepy.

Question 19

How does master clock pacemaker works

Answer 19

Clock genes are expressed in other brain areas and peripheral tissues.

Peripheral clocks are synchronized through humoral, nutrient and autonomic wiring.

Indication that peripheral clock are subordinate to the SCN

Question 20

What are the external cues

Answer 20

light and food

Question 21

Clock osilliator

Answer 21

Brain SCN
Peripherial tissues
with respect endocrine or autonomic innervation

Question 22

what does the core molecular clock consist of

Answer 22

transcription and translation feedback loops

Question 23

Why does Clock and BMAL heterodimeraze

Answer 23

to drive rhythmic expression of downstream target genes
glucose metabolism
lipid homeostasis
thermogenesis

Question 24

circadian disruption can lead to what

Answer 24

dysregulation of body weight

Question 25

what are the two important signals

Answer 25

Leptin ( from the adipose tissue) and Ghrelin ( the stomach )

Question 26

If there is an increase in ghrelin and a decrease in leptin what happens

Answer 26

increase in hunger and appetite

Question 27

what does Orexin A and B do

Answer 27

they have potent wake promoting effects and stimulate food intake

Question 28

what does the orexin system do

Answer 28

it activates the appetite- promoting neuropeptide Y

Question 29

Hypothalamic Orexin Neuron does what

Answer 29

They regulate arousal

Question 30

Insuffcient sleep does what

Answer 30

undermines efforts to reduce adiposity

Question 31

what are uncoupling proteins

Answer 31

they uncouple protein exchange and ATP production

Question 32

name all the sleep disorders

Answer 32

``` Insomnia acute & chronic Depression Poor sleep hygiene Drug induced Fatal Familial Insomnia ```

Question 33

explain narcolepsy

Answer 33

``` lack of orexin producing cells Auto-immune Tetrad of symptoms Irresistible sleepiness Cataplexy Hypnagogic hallucinations Sleep paralysis ```

Question 34

cata plexy what happens

Answer 34

``` Sudden muscle weakness when awake Facial weakness to complete collapse Breathing unaffected Hearing and vision unaffected Atonia of REM intruding into wakefulness Precipitated by emotion (laughter, anger etc ```

Question 35

Obstructive sleep apnoea what happens

Answer 35

Repetitive partial or complete collapse of the upper airway during sleep Heroic snoring Repetitive brief, unrecalled arousals (10-80 per hour) Unrefreshing sleep, daytime sleepiness Middle aged male with large collar size

Question 36

what is nociception

Answer 36

it is the neural process of encoding noxous stimuli

Question 37

how is pain classified: According to duration

Answer 37

Acute Chronic Acute on chronic

Question 38

how is pain classified: according to cause

Answer 38

Primary vs secondary Nociceptive vs neuropathic vs central sensitisation Cancer vs non-cancer

Question 39

How long does acute pain last

Answer 39

``` Pain of less than 6 weeks duration Normal response to a stimulus Mechanical, chemical, thermal Often protective Remove hand from hot surface Reduce movement of broken arm allowing healing Usually responds to treatment ```

Question 40

How long does chronic pain last

Answer 40

persists or recurs for 3 months

Question 41

what is the difference between chronic and acute pain

Answer 41

less than 6 week pain duration for acute recurring every 3 months for chronic

Question 42

what are the differences between primary and secondary chronic pain

Answer 42

P:No alternative diagnosis Significant emotional distress Significant functional disability ``` S:Underlying disease for which pain is a symptom Cancer pain Neuropathic pain Headache or orofacial pain Visceral pain Musculoskeletal pain ```

Question 43

how is pain assessed

Answer 43

``` History Characteristics Intensity Duration Alleviating and exacerbating factors “Red flags” Treatment history Co-morbidities Psycho-social history Examination Investigations ```

Question 44

what is the biopsychosocial model and what does it consist of

Answer 44

``` Bio Physiology Pathology Psycho Emotions Behaviours Beliefs Social Economics Environment Culture Employment ```

Question 45

what is analglesia are there types if so explain

Answer 45

``` Simple analgesics Paracetamol Non-steroidal anti-inflammatory drugs Opioid analgesics Weak opioids e.g. codeine phosphate Strong opioids e.g. morphine, fentanyl, oxycodone, buprenorphine ```

Question 46

what do anti depressants do

Answer 46

block central reuptake of neurotransmitters allowing increased descending inhibitory input

Question 47

examples of anti epileptic and what its used for

Answer 47

Gabapentin, pregabalin Carbemazepine Lamotrigine Prescribed for neuropathic pain

Question 48

what connection does pain and sleep have

Answer 48

bidirectional association

Question 49

what are drugs used to treat sleep disturbance

Answer 49

Benzodiazepines | Z-drugs (zopliclone, zolpidem

Question 50

sleep disorder definition

Answer 50

conditions that affect sleep quality, timing, or duration and impact a person’s ability to properly function while they are awake

Question 51

effects of exercise before sleep give 3 examples

Answer 51

Increase in respiratory rate (amount of breaths per minute), tidal volume (volume of air breathed in/out per breath) and ventilation (air exchange between lungs & environment) Increase heart rate (beats per minute), cardiac output ((amount blood pumped in one minute) & stroke volume (amount blood pumped in one heart beat) – resulting increase in blood pressure. Increase blood flow to working muscles usually away from areas like the digestive system. Increase in metabolic by-products – such as lactate and hydrogen ions Increase in core body temperature Increased sweat rate – the body’s way of cooling your core body temperature & removing excess water Increase muscle recruitment – more muscle fibres begin working and the power & frequency of their contractions increase Increase fuel metabolism – basically how much carbohydrate, fat or protein your body breaks down & uses as a fuel source Increase oxygen consumption by muscles

Question 52

what is exercise induced muscle damage (EIMD)

Answer 52

EIMD is a transient phenomenon caused by unaccustomed, damaging exercise and is characterized by structural damage to myofibers and secondary inflammation resulting from leukocyte infiltration into the damaged tissues.