Study your flashcards anywhere!

Download the official Cram app for free >

  • Shuffle
    Toggle On
    Toggle Off
  • Alphabetize
    Toggle On
    Toggle Off
  • Front First
    Toggle On
    Toggle Off
  • Both Sides
    Toggle On
    Toggle Off
  • Read
    Toggle On
    Toggle Off
Reading...
Front

How to study your flashcards.

Right/Left arrow keys: Navigate between flashcards.right arrow keyleft arrow key

Up/Down arrow keys: Flip the card between the front and back.down keyup key

H key: Show hint (3rd side).h key

A key: Read text to speech.a key

image

Play button

image

Play button

image

Progress

1/62

Click to flip

62 Cards in this Set

  • Front
  • Back
Patient presents with drooping eyelids, fatigue, trouble swallowing, blurred vision, respiratory difficulties, partial paralysis and recurrent episodes of muscle weakness after exercise - diagnosis
MYASTHENIA GRAVIS
Myasthenia gravis affects _ more
WOMEN
Myasthenia gravis chiefly affects what muscles
Supplied by cranial nerves
In myasthenia gravis there is defect in _
Signaling at neuromuscular junction
Describe Tensilon testing
- Injection of Endrophonium is administered
- Test is positive for Myasthenia Gravis if muscles respond in 30 to 45 seconds after injection
- Improvement in strength may persist for 5 minutes
Binding site of nicotinic N1 receptor
Alpha 1 subunit
Subunit of N1 receptor affected in typical MG
Alpha 1 subunit
Acquired slow channel syndrome that is similar to MG but not as severe affects _
DELTA SUBUNIT
In neonatal myasthenia gravis which subunit of N1 is affected
Gamma
80-90% of patients with myasthenia gravis have autoantibodies to _
N1 Ach receptor
Possible triggers of myasthenia gravis
- Drugs (penicillamine)
- Thymoma
- Virus
- genetics
Auto immune disorder against voltage gated Ca channels is called _
Lambert Eaton Syndrome
Ach receptor consists of _ subunits
5
N2 is different from N1 Ach receptor in that it consists of _
Only alpha and beta subunits
Which tests should be done in patient being worked up for Myasthenia Gravis
1) Tensilon test
2)Serum antibody immunoprecipitation test against fetal or adult N1 receptors
3) Repetitive nerve stimulation
4) Scan of thymus
Which drugs are used for treatment of myasthenia gravis
Anticholinesterase inhibitors

- Endrophonium - used for diagnostic tests
- Physostigmine - one of the first used
- Neostigmine
- Pyridostigmine - most prescribed
Inactivates Ach
Acetyl cholinesterase
Other than anticholinesterase inhibitors what treatments are used for Myasthenia Gravis
Steroid medications
Immunosuppressive medications
Thymectomy
Patient presents with pill rolling tremor, bradykinesia, rigidity and postural instability - diagnosis
PARKINSONS
Major input to substantia nigra
Caudate and putamen
Parkinsons disease is caused by _
Loss of pigmented DA producing cells from substantia nigra
When do you start showing symptomps in Parkinsons
When 80-90% of DA producing neurons in substantia nigra are gone
Characteristic neuropathology of Parkinsons is presence of _
LEWY BODIES
Which radio tracer is used for PET scanning when look for Parkinsons
6-fluoro-dopa
How can you increase synthesis of DA
By using L dopa
Why can L dopa be administered to increase dopamine production but dopamine itself cannot when treating Parkinsons
DOPAMINE does NOT cross BBB

L DOPA CROSSES BBB
Carbidopa is usually administered with L DOPA - why
To block conversion of L dopa to dopamine outside of brain since dopamine has peripheral effects
Which enzyme breaks down dopamine
MAO
Name drugs that block degradation of dopamine
MAO INHIBITORS

DEPRENYL
SELEGILINE
TOLCAPONE
ENTACAPONE
Name dopamine receptor agonist
Bromocriptine
Marker for DA turnover
HVA - homovallinilic acid
Describe breakdown of DA
DA - DOPAL - DOPAC- HVA
Side effect of L dopa is _
Hallucinations
Name drugs that induce Parkinson like symptoms
RESERPINE (for hypertension) - prevents repackaging of DA

CHLORPROMAZINE (antipsychotic) - dopamine receptor antagonist
Anticholinergics have some use in treating Parkinsons - T/F
TRUE
MAO inhibitor and dopamine reuptake blockers prevent _ damage and show at least some protection against _
MPTP

PARKINSONS
Patient presents with hallucinations, delusions, bizzare behavior, social withdrawal and emotional blunting - diagnosis
SCHIZOPHRENIA (affects 1% of people in US, 9-13% suicide rate)
In SCHIZOPHRENIA there is altered orientation of _ which involved in cells _
Hippocampal pyramidal cells

Migration and adhesion
Enlarged ventricles are noted in _
Schizophrenics
What is biochemically wrong in schizophrenia
ELEVATED DOPAMINE LEVELS

Elevated dopamine metabolites in CSF - HVA

Elevated numbers of DA receptors (D2) in brain
Mechanism of action of typical antipsychotics
Side effects?
Block DA TRANSMISSION - Parkinson like side effects
Activation of 5HTa and 5HTc receptors causes _
Hallucinations (this receptor is activated by LSD)
Mechanism of action of atypical antipsychotics
Block serotonin
Progressive impairment of cognitive function (dementia)occurs in patients with _
ALZHEIMERS
Hallmarks of Alzheimers
Plaques and tangles - protein amyloid beta peptide and tau protein
Amyloid proteins stain _
Blue with iodine
Plaque in Alzheimers is composed of _ derived from _
Amyloid beta peptide

Proteolysis of Amyloid precursor protein (APP)
Why are amyloid beta peptides neurotoxic
Increase intracellular Ca
Gene for Alzheimers is found on _
Chromosome 21
Primary pathological event in Alzheimers
Extracellular deposition of amyloid beta peptide
_ are reduced in Alzheimers
Ach and CHAT
Mutation of those genes can lead to Alzheimers
APP - amyloid precursor protein

Presenilin

Apolipoprotein E
How is Huntingtons inherited
Autosomal dominant
In Huntingtons neurons in _ die
Corpus striatum
Gene responsible for Huntingtons has been isolated on chromosome _ - it encodes protein called _
4

Huntingtin
What goes wrong on genetic level in patients with Huntingtons
INCREASE IN CAG REPEATS (from normal 10-20 to 120)
In patients with Huntingtons there is excessive _
Glutamate- blockage of GABA receptor and release of excessive glutamate - EXCITOTOXICITY
Why does excessive glutamate in patients with Huntingtons kills cells
NMDA receptors let Ca in
Which drugs are used to control choreic movements in patients with Huntingtons
Benzodiazepines - GABA enhancers
In patients with stroke there is extra release of _
GLUTAMATE --> EXCITOTOXICITY
Ischemia triggers _
GLutamate release from oxygen-starved neurons
Alcohol for a long time increases _ --> this _ receptors --> withdrawal seizures
GABA

DOWNREGULATES