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126 Cards in this Set
- Front
- Back
Cells destroyed in Multiple Sclerosis
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Oligodendrcytes
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Cells look like fried eggs on H&E Stains
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Oligodendrocytes
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Phagoctes in the CNS that fuse to form Multinucleated Giant Cells when infected with HIV
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Microglia
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Astrocyte response to injury
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Reactive gliosis
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Wallerian degeneration
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neuron degeneration distally when axon is injured
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Emerge from neural crest cells
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Schwann cells; PNS neurons
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Cells that are destroyed in Guillain Barre
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Schwann Cells
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Typical neuron found in internal acoustic meatus
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Acoustic neurooma- a type of scwanoma
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Anxiety NT Changes
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Increased Norepinephrine
Decreased Serotonin Decreased GABA |
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Depression NT Changes
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Decreased Norepinephrin
Decreased Dopamine Decreased Serotonin |
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Schizophrenia NT Changes
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Increased Dopamine
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Parkinsons NT Changes
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Decreased Dopamine
Increaesd ACh |
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Huntingtons NT Changes
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Decreased ACh
Decreased GABA |
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Increased REM Sleep NT Responsible
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Increased ACh
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Alzheimers NT Changes
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Decreased ACh
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What vitamin is needed for conversion from Glutamate to GABA?
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Vitamin B6- without it, you get convulsions
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How do glucose and amino acids cross the BBB?
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Slowly- by carrier mediated transport
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How do lipid soluble substances cross the BBB?
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Rapidly- via diffusion
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Lateral area hypothalamus
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Controls hunger
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Ventromedial area hypothalamus
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Controls satiety
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Posterior pituitary products
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Oxytocin; ADH
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Thalamic nucleus for face sensation and taste
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Ventral Posteromedial Nucleus (VPM
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What is the limbic system responsible for?
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The famous 5 F's:
Feeding, Fleeing, Fighting, Feeling, and sex. |
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Injury to the medial cerebellum leads to propensity to fall toward
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Ipsilateral side
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Lesion to Substantia Nigra pars compacta
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Causes hypokinesis because the SNpc functions to stimulate movement
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Lesion to the caudate
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Causes hyperkinesis (Huntingtons) because the caudate functions to inhibit movement
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Degeneration of Putamen
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Causes Wilson's disease
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Two causes of hyporeflexia
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Peripheral nerve lesion
Mg+2 XS |
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Lesion to the contralateral subtalamic nucleus
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Sudden, wild flailing of an arm and/or leg...hemiballismus
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Athetosis
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Slow, writhing movements, esp. fingers. (basal ganglia lesion)
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Central sulcus
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Separates principal motor and principal sensory areas
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Broca's area
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Frontal lobe
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Wernicke's area
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Temporal lobe
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Arterial supply to lower limbs areas of sensory and motor areas
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Anterior cerebral artery
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Arterial supply to face and upper extremities
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Middle cerebral artery
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Disinhibited behavior, hyperorality, hypersexuality associated with HSV 1
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Kluver Bucy Syndrome
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Confusion, ophthalmoplegia, Ataxia, Memory loss, confabulation, personality changes associated with thiamine deficiency
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Wernicke Korsakoff Syndrome (lesion to the mammillary bodies)
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Intention tremor from lesion
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Cerebellar hemisphere
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Truncal ataxia, dysarthria results from lesion
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Cerebellar vermis
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Commonly caused by very rapid corection of hyponatriemia
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Central pontine myelinolysis
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Can't repeat phrases such as "No ifs, ands, or buts"
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Conduction aphasia
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Pulsating exopthalmos indicates what?
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Rupture of Internal Carotid Artery
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Most common site for berry aneurysms
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Bifurcation of Anterior Communicating Artery
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Common site for berry aneurysms causing CN III palsy (eye is "down and out")
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Psoterior Communicating Artery
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Wallenberg's syndrome
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Lateral medullary syndrome- lots of different symptoms (vomiting, vertigo, decreased sensation to face, dysphagia, hoarseness). Damage to PICA
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Middle meningeal artery rupture
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Epidural hematoma
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Bloody or yellow spinal tap
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Xanthochromia indicative of subarachnoid hemorrhage
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Tx for Subarachnoid hemorrhage
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Nimodipine
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Layers of tissue for lumbar puncture
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Skin, fascia, supraspinous ligament, infraspinous ligament, ligamentum flavum, epidural space, dura mater, sub dural space, arachnoid mater, subarachnoid space
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Placement of Lumbar puncture
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Between L3 and L5 in Adults
Between L5 and S1 in Kids |
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Commonly used by patients first line for insommnia treatment
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Antihistamines
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Antideppressent also used for sleep
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Trazodone
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First line treatment for narcoleps
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Modafinil
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When can nocturnal enuresis be treated?
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Diagnosed at 5yo
Treatment is delayed until 7yo |
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EEG waveform awake
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Beta wave
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EEG waveform eyes closed
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Alpha wave
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EEG Stage 1
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Theta wave
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EEG stage 2
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Sleep spindles and K complexes
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EEG stage 3
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Delta wave
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REM EEG
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Beta wave
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Cranial nerves with nuclei in medulla
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CN IX, X, XI, XII
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Cranial nerves with nuclei in pons
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CN V, VI, VII, VIII
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Cranial nerves in midbrain
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CN III, IV
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Information communicated at nucleus solitarius
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Sensory Info
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Information communicated at nucleus ambiguus
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Motor Info
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Information communicated at the dorsal motor nucleus
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Autonomic info
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Muscles of mastication
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Masseter, Medial pterygoid, temporalis, Lateral pterygoid
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Deviation of tongue CN XII LMN lesion
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Toward side of lesion
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Deviation of CN V motor lesion
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Jaw deviates toward side of lesion
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Distinguish Bells Palsy from Stroke
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Stroke will affect contralateral lower face; bells palsy will affect ipsilateral entire face
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Patient with bilateral Bell's Palsy
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Guillan Barre
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Midbrain infarction with oculomotor nerve palsy and contalateral hemiparesis
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Weber syndrome
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Roral medulla infarction causing contalateral pain/temp loss, ipsilateral face pain and temp loss, difficulty swallowing, ipsilateral horner's
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Wallenberg Syndrome
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Lesion of what artery causes locked in syndrome?
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Basilar artery
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Presents as floppy baby with tongue fasciculations
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Werdnig Hoffman disease
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Transmitted by the fecal oral route, causes destruction of cells in anterior horn of spinal cord leading to flaccid paralysis, hyporeflexia, atrophy
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Polio virus
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Can be caused by defect in superoxide dismutase
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Amyotrophic lateral sclerosis
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Degeneration of dorsal columns and dorsal roots due to tertiary syphilis resulting in impaired proprioception and locomotor ataxia
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Tabes dorsalis
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Autosomal recessive rinucleotide repeat disorder (GAA) in a gene that encodes frataxin
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Friedreich's ataxia
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Brown sequard syndrome
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Contralateral loss of pain and temperature below
Ipsilateral loss of vibration, proprioception, fine touch below Ipsilateral UMN signs below Ipsilateral loss of all sensation at level LMN signs at level |
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Differential diagnosis for cotton wool spots
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DM, HTN, AIDS
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Obstructed outflow at Canal of Schlemm- bilateral, black, 40yo, Diabetes
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Open angle glaucoma
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Afferent pupillary defect with decreased bilateral pupillary constriction when light is shone in affected eye
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Marcus Gunn pupil
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Lesion in medial longitudinal fasciculus
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Internuclear ophthalmoplegia
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Amyloid Precursor Protein on Chromosome 21 (hence, Down syndrome associated) associated with this dementia
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Alzheimer's Disease
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Dementia caracterized by personality and behavioral changes
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Pick's Disease (Frontotemporal dementia)
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Parkinsonism with dementia and hallucinations
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Lewy Body Dementia
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Rapidly progressive dementia with myoclonus
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Creutzfeld Jakob Disease
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Charcot's triad for Multiple Sclerois
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Scanning speech, Intention Tremor, Nystagmus ("SIN")
I can also mean Incontinence or Internuclear ophthalmoplegia |
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Periventricular plaques
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Multiple sclerosis
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Mechanism for Guillain Barre
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Postinfection; autoimmune attack of peripheral myelin due to molecular mimicry
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Seizure in one area of brain in which consciousness is impaired
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Complex partial seizure
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Diffuse seizure with blank stare
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Absence seizure
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Treatment for migraine headache
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Propranolol, NSAIDs, Sumatriptan
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Treatment for cluster headache
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Inhaled oxygen, sumatriptan
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Maneuvers for vertigo
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Dix-Hallpike Test; Epley maneuver seem to work for misplaced otoliths
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Excess fluid in inner ear causing vertigo
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Meniere's Disease
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Port wine stains, glaucoma, seizures, hemiparesis, mental retardation
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Sturge Weber Syndrome
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Tuberous sclerosis tumors
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Adenoma sebaceum; Cardiac Rhabdomyopa; Renal angiomyolipoma
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Mutated gene on chromosome 17 causing Cafe au lait spots and Lisch nodules
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Neurofibromatosis type I
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Drugs that decrease aqueous humor synthesis for glaucoma
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Alpha agonists- Epinephrine, Brimonidine
Beta blockers- Timolol, betaxolol, cartelol Diuretics- Acetazolamide |
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Side effect of epinephrine use in glaucoma
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Mydriasis; therefore, do not use in closed-angle glaucoma
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Glaucoma drugs that increase outflow of aqueous humor
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Cholinomimetics:
Direct- pilocarpine, carbechol Indirect- physosigmine, echothiophate Prostaglandins: Letanoprost |
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Side effect of letanoprost
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(Used in glaucoma tx)
Darkens color of iris |
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Drug of choice in glaucoma emergency
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Pilocarpine
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Mechanism of action of opiod analgesic
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Agonists at opiod receptors in medial thalamus, brainstem, and spinal cord to open potassium channels and close calcium channels leading to decreased synaptic transmission.
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Reverses overdose of opiates
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Naloxone or Naltrexone
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Acetylation is the reason this drug is three times more potent than morphine
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Heroin
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Overdose of Opioid leads to this clinical picture
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Respiratory depression, miosis
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Drug of choice for partial seizures (simple and complex)
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Carbamazepine
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1st line drugs for tonic clonic seizures
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Phenytoin, Carbamazepine, Valproic acid
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Absence seizure DOC
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Ethosuximide
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DOC to stop ongoing or recurrent febrile seizures
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Phenobarbital
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Drug of Choice in Status Epileptius treatment
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Prophylaxis: Phenytoin
Acute: Diazepam/Lorazepam |
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Seizures of ecclampsia
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IV Mg Sulfate
Diazepam |
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SE gingival hyperplasia
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Phenytoin
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Fetal hydantoin syndrome SE
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Phenytoin
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Fetal neural tube defects SE
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Valproic acid
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Epilepsy drugs taht cause SJS
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Carbamazepine, Ethosuximide, Lamotrigine
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Difference between Barbituates and Benzodiazepines MOA
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Barbs increase duration of Cl channel opening; Benzos increase frequency of Cl channel opening
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Most common drug used for endoscopy
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Midazolam
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Contraindicated in patients with intermittent porphyria
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Thiopental
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IV anaesthetic contraindicated in HTN or stroke patients
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Ketamine
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Order of nerve blockade by local anesthetics
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Small myelinated>small unyelinated>large myelinated>large unmyelinated
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Types of local anesthetics
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Esters and Amides. Amides have "two eyes" ex: mepIvacaIne (mepivacaine)
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Explain the strategy of the following drugs in Parkinson treatment:
Bromocriptine Amantadine Levodopa Selegiline Antimuscarinics |
Bromocriptine: agonize DA receptors
Amantadine: may incr. DA release Levodopa: converted to DA Selegiline: MAO type B inhibitor (prevents DA breakdown) Antimuscarinic: benztropine- improves tremor and rigidity, little effect on bradykinesia |