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303 Cards in this Set
- Front
- Back
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Patient has decreased pain and temperature sensation over lateral aspects of both arms. What's the disease process?
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syringomyelia
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penlight in patient's right eye produces bilateral pupilary constriction. If shined in the left eye, there is dilation. What's the problem?
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atrophy of the left optic nerve
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Women in a MHC can't turn her head to the left and has right shoulder droop. What structure is damaged?
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accessory nerve (CN XI)
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Man presents with 1 wild, flailing arm. Where is the lesion in the nervous system?
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contralateral subthalamic nucleus. He has hemiballismus, by the way.
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PAtient with a cortical lesion does not know that he has a disease. Where is the lesion?
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right parietal lobe
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Patient's tongue veers to the left side, and patient has a right-sided spastic paralysis. Where is the lesion?
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Left medulla and hypoglossal nerve (CN XII)
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PAtient can't blink his right eye, or seal his lips. What's the diagnosis, and where is the lesion?
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Bell's palsy, problem with the facial nerve (CN VII)
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Woman presents with headache, visual disturbance, galactorrhea, and amenorrhea. What's the diagnosis?
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prolactinoma
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43-year old man has dizziness and tinnitis. CT shows an enlarged interal acoustic meatus. What's the diagnosis?
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Schwannoma
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25-year old woman has sudden vision loss in one eye, slurred speech. Has a Hx of weakness and parasthesias that have resolved. What's the Dx?
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Multiple Sclerosis
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10-year old kid spaces out occasionally, then resumes activities like nothing happened. His lips quiver a little during these spells. What does he have?
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Absence seizures
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23-year old woman in a MVC. Feels fine at first, then loses consciousness. CT scan shows intracranial hemorrhage that does not cross suture lines. What was injured in the crash?
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middle meningeal artery, resulting in epidural hematoma
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38-year old man with Marfan's and hypertension presents with a severe headache. Spinal tap shows blood in the CSF. What is going on?
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subarachnoid hemorrhage due to ruptured berry aneurysm
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78-year old Alzheimers man falls down, presents 3 days later with severe headache and vomiting. What structure was damaged?
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Bridging veins, resulting in subdural hematomas
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What is the role of astrocytes in the CNS?
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maintain blood-brain-barrier, physical support, K+ metabolism
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What is the role of ependymal cells in the CNS?
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line the ventricles, make CSF
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What is the role of microglia in the brain?
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they are the macrophages of the brain
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What is the role of oligodendroglia in the CNS?
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myelin production
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What is the role of Schwann cells in the PNS?
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myelin production
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All the cells of the CNS and PNS are derived from what germ layer? There's one exception, though; which layer is that cell derived from?
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ectoderm. Microglia are the exception, and they come from the mesoderm
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Where in the brain is norepinephrine manufactured?
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locus ceruleus
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Where in the brain is dopamine manufactured?
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ventral tegmentum, and the substantia nigra
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Where in the brain is serotonin manufactured?
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raphe nucleus
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Where in the brain is acetylcholine manufactured?
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basal nucleus of Meynert
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Which layer of the nerve sheath must be reconnected during microsurgery in order that the nerve axons grow back together?
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the perineurium
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What 3 structures form the blood-brain barrier?
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astrocyte processes, basement membrane, non-fenestrated capilllaries
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Where in the brain is there no blood-brain-barrier?
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area postrema, posterior pituitary gland
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What part of the hypothalamus controls thirst and water balance?
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supraoptic nucleus
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What part of the hypothalamus activates to cause hunger?
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lateral area
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What part of the hypothalamus activates to cause satiety?
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ventromedial area
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Which part of the hypothalamus controls circadian rhythms?
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suprachiasmatic nucleus
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Which part of the hypothalamus controls the parasympathetic nervous system?
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anterior area
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Which part of the hypothalamus controls the sympathetic nervous system?
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posterior area
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What part of the hypothalamus heats you up when you're cold?
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posterior area
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What part of the hypothalamus cools you down when you are hot?
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anterior area
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What part of the hypothalamus controls sexual urges and rage?
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septal nucleus
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Which nucleus in the hypothalamus secretes oxytocin from its axons in the posterior pituitary?
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paraventricular
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Which nucleus in the hypothalamus secretes ADH from its axons in the posterior pituitary?
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supraoptic
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What part of the thalamus does the optic nerve travel through?
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lateral geniculate
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What part of the thalamus does the acoustic nerve travel through?
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medial geniculate
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What nerves travel through the VA/VL part of the thalamus?
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motor nerves
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What nerves travel through the VPM part of the thalamus?
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facial sensation
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What nerves travel through the VPL part of the thalamus?
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body sensation
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What structures make up the limbic system?
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cingulate, hippocampus, fornix, mamillary bodies
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What does the limbic system control?
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fighting, fleeing, feeding, feeling, and sex
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What nerves serve as the input to the cerebellum?
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climbing fibers, mossy fibers
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What nerves serve as the output from the cerebellum?
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purkinje fibers
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what are the inputs to the caudate and putamen, and are they excitatory or inhibitory?
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cortical input is excitatory. dopaminergic input from the substantia nigra is either excitatory (D1) or inhibitory (D2)
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What are the outputs of the caudate and putamen, and are they excitatory or inhibitory?
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when stimulated, the caudate/putamen INHIBITS the globus pallidus internus and globus pallidus externus
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Is the globus pallidus internus excitatory or inhibitory, and where do its outputs go?
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they go to the thalamus, and they are inhibitory
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Where is the output of the globus pallidus externus, and is it excitatory or inhibitory?
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goes to the subthalamic nucleus, and its inhibitory
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Where does the output from the subthalamic nucleus go, and is it excitatory or inhibitory?
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goes to the globus pallidus internus, and it is inhibitory
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precentral gyrus of the cortex contains what?
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motor neurons for the body
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the postcentral gyrus of the cortex contains what?
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sensory neurons for the body
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What two structures does the arcuate fasciculus connect?
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broca's area with wernicke's area
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Is the motor control for the foot closer to the cingulate gyrus or the sylvian fissure?
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cingulate gyrus
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Is the motor control for the lips closer to the cingulate gyrus or the sylvian fissure?
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sylvian fissure
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Is the sensory control for the foot closer to the cingulate gyrus or the sylvian fissure?
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cingulate gyrus
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Is the sensory control for the lips closer to the cingulate gyrus or the sylvian fissure?
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sylvian fissure
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What areas of the cortex are supplied with blood by the posterior cerebral artery?
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occipital lobe, inferior temporal lobe, posterior areas within the cleft between the hemispheres
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what area of the brain is supplied with blood by the anterior cerebral artery?
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anterior and middle parts of the area inside the cleft between the hemispheres
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what area of the brain is supplied by the middle cerebral artery?
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areas surrounding the sylvian fissure
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What is the most common site of aneurysms in the circle of willis? What defects can it cause?
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anterior communicating arteries. aneurysm causes visual field defects
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Aneurysm of the posterior communicating artery in the circle of willis causes.....what?
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oculomotor nerve palsy (CNIII)
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What branch of the circle of willis supplies blood to the caudate, putamen, and globus pallidus?
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lateral striate
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Stroke of the anterior part of the circle of willis manifests in what kind of deficits?
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general sensory/motor dysfunction, aphasia
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Stroke of the posterior part of the circle of willis manifests in what kind of deficits?
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cranial nerve problems like vertigo and visual problems, coma, ataxia
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What connects the lateral ventricles with the third ventricle?
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foramen of monro
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What connects the third ventricle with the fourth ventricle?
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cerebral aqueduct
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What connects the fourth ventricle with the subarachnoid space of the brain and spinal cord?
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foramen of luschka, foramen of magendie
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How many spinal nerves are there? What's the division amongst C,T,L,S?
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31 total
8 cervical, 12 thoracic, 5 lumbar, 5 sacral, and 1 coccygeal |
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At what level does the spinal cord stop?
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usually between L1 and L2
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What information is carried in the cuneatus dorsal columns of the spinal cord?
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pressure, vibration, proprioception of the ipsilateral upper body and arm
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What information is carried in the gracilis dorsal columns of the spinal cord?
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pressure, vibration, proprioception of the ipselateral lower body and legs
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Which structure is more medial in the spinal cord: cuneatus or gracilis?
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gracilis is medial, cuneatus is lateral
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What information is carried in the spinothalamic tract?
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pain and temperature from the contralateral body
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In the spinothalamic tract, where do cervical nerves ascend compared to sacral nerves?
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cervical nerves are medial, sacral nerves are lateral
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What information is carried in the lateral corticospinal tract in the spinal cord?
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voluntary motor movement to the ipsilateral body
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Where do dorsal column neurons decussate?
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in the medulla
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Where do spinothalamic neurons decussate?
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pretty much as they enter the spinal cord
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Where do corticospinal nerves decussate?
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pyramids of the medulla
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What dermatome is at the levels of the nips?
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T4
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What dermatome is at the level of the belly button?
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T10
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What dermatome is at the level of a high turtleneck shirt?
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C3
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What dermatome is at the level of a T-shirt collar?
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C4
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What dermatome is at the level of the inguinal ligament?
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L1
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What dermatome is the level of the kneecap?
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L4
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What dermatome is the base of the penis?
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S2
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What dermatome is the tip of the penis?
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S4
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what do muscle spindles sense?
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muscle fiber stretch. Helps you lift a suitcase when you didn't know how heavy it was.
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What does the Golgi tendon organ sense?
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muscle tension. Causes relaxation if the fiber has been contracted too long. Prevents fiber damage.
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What nerve does the biceps reflex test?
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C5 root
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What nerve does the triceps reflex test?
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C7 root
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What nerve does the patellar reflex test?
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L4 root
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What nerve does the achilles reflex test?
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S1 root
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What is the Moro reflex?
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extension of limbs when startled. Normal in infants, re-emergence means there's a problem
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What is the Babinski reflex?
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dorsiflexion of big toe when plantar surface is stimulated. Normal in infants, re-emergence means there's a problem.
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What information passes through the superior colliculi?
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coordinates vision with body movement
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What information passes through the inferior colliculus?
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coordinates hearing with body movement
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What is Parinaud Syndrome?
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paralysis of conjugate vertical gaze due to lesions on the superior colliculus
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What symptoms will show up in a person with a PICA infarct?
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same sided ataxia, nystagmus, and loss of pain/temperature sensation in the face. opposite sided loss of pain/temperature sensation of the body
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What modality is CN2?
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optic nerve: sensory from the retinas
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what modality is CN3?
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oculomotor nerve: motor. eye movement, eye opening, pupil constriction
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what modality is CN4?
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trochlear nerve: motor, eye intorsion and looking down-medially
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what modality is CN5?
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trigeminal nerve: motor -> mastication, sensory -> facial skin
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What modality is CN6?
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abducens: motor, moves the eye laterally
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What modality is CN7?
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facial: motor: facial movement, stapedius, salivation, lacrimation. Sensory: taste from front 2/3 of tongue
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What modality is CN8?
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vestibulorcochlear: sensory, hearing and balance from the ears
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what modality is CN9?
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glossopharyngeal: sensory, taste from the back 1/3 of tongue, carotid baro- and chemo-receptors. Motor: stylopharyngeus, initiate swallowing
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What modality is CN10?
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vagus. sensory: taste from epiglottis, aortic chemo-baro-receptors. Motor: all laryngeal/pharyngeal muscles, swallowing, parasympathetic GI
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what modality is CN11?
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accessory. Motor, SCM and trapezius. shrugged shoulders, head turning
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what modality is CN12?
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hypoglossal. motor, tongue movement
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Which cranial nerve nuclei are located in the midbrain?
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3 and 4
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Which cranial nerve nuclei are located in the pons?
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5,6,7,8
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Which cranial nerve nuclei are located in the medulla?
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9,10,11,12
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Which cranial nerves are involved in the corneal reflex?
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afferent - CN5
efferent - CN7 |
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Which cranial nerves are involved in the lacrimal reflex?
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afferent - CN5
efferent - CN7 |
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Which cranial nerves are involved in the jaw jerk reflex?
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afferent - CN5
efferent - CN5 |
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Which cranial nerves are involved in the pupillary reflex?
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afferent - CN2
efferent - CN3 |
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Which cranial nerves are involved in the gag reflex?
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afferent - CN9
efferent - CN9,10 |
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What information passes through the nucleus solitarius?
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taste and other sensory infomation from CN7,9,10
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What information passes through the nucleus ambiguous?
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motor control to the palate and throat, CN9,10
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What information passes through the dorsal motor nucleus?
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parasympathetic motor control to the heart, GI, and lungs through CN10
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What nerves run through the superior orbital fissure?
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CN3,4,5(ophthalmic),6
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what nerves run through the foramen rotundum?
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CN5
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What nerve runs through the foramen ovale?
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CN5
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What nerves run through the internal auditory meatus?
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CN7,8
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What nerves run through the jugular foramen?
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CN9,10,11
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Which nerves run through the cavernous sinus?
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CN3,4,5,6
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Which nerve runs along with the internal carotid artery, free-floating in the cavernous sinus?
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CN6
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Which nerves are responsible for the sounds made by K, L, and M?
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K - vagus
L - hypoglossal M - facial |
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What muscles close the jaw?
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masseter, temporalis, medial pterygoid
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What muscle opens the jaw?
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lateral pterygoid
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what kind of nerve endings sense pain and temperature? what is their distribution?
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free nerve endings (c fibers, a-delta fibers), found everywhere
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What kind of nerve endings sense vibration? what is there distribution?
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pacinian corpuscles, found in the deep skin layers
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What nerve endings sense dynamic touch and manipulation? what is their distribution?
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meissner's corpuscles, found on hairless skin, fingertips
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What nerve endings sense staic touch and textures? what is their distribution?
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merkel's disks, found in hair follicles and fingertips
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where would you find endolymph? what ion is it rich in?
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endolymph fills the cochlea, semicircular canals, utricle, and saccule. high in K+
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Where does the problem lie in conductive hearing loss?
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problems with the eardrum, auditory bones, or ear canal
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Where does the problem lie in sensorineural hearing loss?
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problems with the hair cells, cochlea, or auditory nerve
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An eye with CN3 damage will direct its gaze.....?
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down and out
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An eye with CN4 damage will direct its gaze......?
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medial gaze will drift upward
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an eye with CN6 damage will direct its gaze......?
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medially
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What is the job of the Endinger-Westphal nucleus?
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causes both pupils to constrict when light is shined into one eye
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a lesion on the left medial longitudinal fasciculus will cause what problem?
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When looking to the right, left eye can't look medially and right eye will have nystagmus. convergence is unaffected
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Neural tube defects in a fetus will show up how in the mother?
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elevated alpha fetoprotein in maternal blood
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What is spina bifida occulta?
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failure of vertebrae bone to close, but spinal cord and dura are normal. Common, usually asymptomatic
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What is a meningocele?
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failure of vertabrae bone to close, meninges herniate through the opening, spinal cord is normal
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What is a myelomeningocele?
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failure of vertebral bone to close, meninges and spinal cord herniate out through the opening
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What parts of the brain and ventricles form from the telencephalon?
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cerebrum, lateral ventricles
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What parts of the brain and ventricles form from the diencephalon?
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thalamus and associated parts, 3rd ventricle
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What parts of the brain and ventricles form from the mesencephalon?
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midbrain, cerbral aqueduct
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What parts of the brain and ventricles form from the metencephalon?
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pons and cerebellum, 4th ventricle
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What parts of the brain and ventricles form from the myelencephalon?
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medulla and 4th ventricle
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What is holoprosencephaly? What can cause it?
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decreased separation of the two cerebral hemispheres. can be caused by fetal alcohol syndrome and Patau's syndrome
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What are some signs that a fetus has anencephaly?
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polyhydramnios, elevated maternal alpha-fetoprotein
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What parts of the spinal cord are affected by poliomyelitis and Werdnig-Hoffman disease?
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anterior horns. Leads to flaccid paralysis.
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What parts of the spinal cord does multiple sclerosis affect?
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random patches of the cervical spinal cord, leading to tremor, nystagmus, halting speech
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What parts of the spinal cord does Amyotrophic Lateral Sclerosis (Lou Gehrig's disease) affect?
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both upper and lower motor neurons, in the anterior horns and corticospinal tract. No sensory deficits.
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Occlusion of the anterior spinal artery will leave what spinal tracts intact?
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dorsal column/medial lemniscus, and lissaur's tract
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What parts of the spinal cord are affected by 3rd degree syphilis?
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dorsal column/medial lemniscus, and the dorsal roots. Reduced proprioception, ataxia, tabes dorsalis
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what parts of the spinal cord are affected by syringiomyelia?
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decussation of spino-thalamic tract. Results in bilateral loss of pain and temperature sensation
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Vitamin B12 neuropathy results in damage to what parts of the spinal cord?
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dorsal columns, corticospinal tract, corticocerebellar tract. Leads to ataxic gait, hyperreflexia, impaired proprioception and vibration sense
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What symptoms make up Friedreich's Ataxia?
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ataxic gait, hyperreflexia, impaired proprioception and vibration sense
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What other disorder is associated with syringiomyelia?
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Arnold-Chiari malformation
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What is Brown-Sequard Syndrome?
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hemisection of the spinal cord.
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What are the symptoms of Brown-Sequard Syndrome?
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ipsilateral loss of tactile, proprioception, vibration, and UMN signs below lesion, contralateral loss of pain and temperature below lesion.
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unilateral Ptosis, Anhidrosis, flushing, and pupillary miosis suggest what syndrome? What causes it?
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Horner's syndrome, caused by spinal cord injury above T1. Lack of sympathetic ennervation causes the symptoms
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Broca's aphasia manifests as what, now?
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can't speak, but good comprehension
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Wernicke's aphasia manifests as what, now?
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speaks lots of nonsense, but can't comprehend directions
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A lesion of the arcuate fasciculus will manifest, how?
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patient can speak, has good comprehension, but can't repeat words in a row
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A lesion of the amygdala will manifest, how?
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hypersexual, lots of talking, disinhibited behavior
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What is Kluver-Bucy syndrome?
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a lesion of the amygdala, leading to hypersexuality, chatterboxing, disinhibition
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A lesion of the frontal lobe will manifest how?
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personality changes, can't concentrate, loss of judgement, primitive reflexes re-emerge
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A lesion of the right parietal lobe will manifest how?
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they will totally ignore the left half of the world
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A lesion of the reticular activating system will manifest how?
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reduced arousal, coma
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In Wernicke-Korsakoff syndrome, what area of the brain will be damaged?
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mamillary bodies
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Lesions in the basal ganglia will manifest how?
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resting tremor, chorea, athetosis (writhing movements)
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Lesions in the cerebellar hemispheres will manifest how?
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intention tremor, limb ataxia
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Lesions in the cerebellar vermis will manifest how?
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truncal ataxia
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Lesions of the subthalamic nucleus will manifest how?
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hemiballismus (sudden, explosive movements)
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Lesions to the hippocampus will manifest how?
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anterograde amnesia (can't form new memories)
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What microscopic changes will you see in a brain with Alzheimer's disease? are they intracellular, or extracellular?
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extracellular beta-amyloid plaques, intracellular tau protein tangles
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What are the manifestations of Pick's disease?
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dementia, aphasia, parkinsonian movements
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What microscopic changes will you see in a brain with Pick's disease?
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intracellular tau protein tangles (Pick bodies) in the frontotemporal lobes
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What are the manifestations of Lewy Body Dementia? What causes it?
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parkinsonian movements with dementia and hallucinations, caused by alpha-synuclein defects
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What are the manifestations of Creuztfeld-Jakob Disease?
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rapid onset, rapidly progressive dementia and muscle twitching
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Huntington's Disease causes what symptoms?
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chorea, dementia
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What macroscopic changes are seen in the brain of a person with Huntington's disease?
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atrophied caudate leads to enlarged lateral ventricles
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What are the genetics of Huntington's Disease?
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autosomal dominant. CAG repeats leads to loss of GABA neurons in the caudate nucleus
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Parkinson's Disease causes what symptoms?
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resting tremor, rigidity, akinesia, bad posture
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What is the molecular problem in people with Parkinson's disease?
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Lewy bodies (alpha synuclein) lead to death of dopamine-producing neurons, depigmented substantia nigra
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Defects in superoxide dismutase 1 can lead to what neurological problem?
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Amyotrophic Lateral Sclerosis
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What syndrome is autosomal-recessive, presents at birth as "floppy baby" syndrome, and involves the degeneration of lower motor neurons?
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Werndig-Hoffmann Disease
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what disease is associated with periventricular plaques in the brain, high IgG in the CSF, and is found usually in young women?
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Multiple Sclerosis
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What is the treatment for Multiple Sclerosis?
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beta interferon or immunosuppressants
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What virus causes progressive multifocal leukoencephalopathy? In what context?
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JC virus causes it, usually in AIDS patients
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what is the name of the autosomal-recessive lysosomal storage disease where you have a deficiency in arylsulfatase A?
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metachromic leukodystrophy
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What causes Gullain-Barre syndrome?
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cross reaction of pathogens (campylobacter, herpesvirus)with your own peripheral myelinated nerves
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What are the symptoms of Guillain-Barre Syndrome?
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ascending peripheral muscle weakness, autonomic dysfunction, facial paralysis. Sensory nerves less affected.
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What is the treatment for Guillan-Barre Disease?
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respiratory support, plasmaphoresis, IV immunoglobins. Disease is self-limiting and goes away after a few weeks to months
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What are the lab findings in people with Guillain-Barre Disease?
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Elevated CSF protein with normal CSF cell count
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What is the difference between a partial seizure and a generalized seizure?
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partial seizures affect one focal part of the brain, and generalized seizures affect the whole brain diffusely
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What is the difference between a simple partial seizure and a complex partial seizure?
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simple partial = person stays conscious
complex partial = person looses consciousness |
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What are the 5 types of generalized seizures?
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Absence - blank stare
Myoclonic - repetative jerks Tonic-Clonic - rigid then spastic Tonic - rigid Atonic - all muscles relax |
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Genetic seizures are almost always seen in what population?
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children
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What does an epidural hematoma look like on CT, and what vessel is broken?
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biconcave disk, does not cross suture lines. Usually, bleeding is from middle meningeal artery
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What does a subdural hematoma look like on CT, and what vessel is broken?
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cresent shape, crosses suture lines. Usually, bleeding is from ruptured veins
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Subarachnoid hemorrhages are usually secondary to what?
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ruptured berry aneurysms
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What is characteristic of patients with a subdural hematoma?
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they have delayed symptoms, and injury is usually due to blunt trauma or whiplash in a MVC
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What is characteristic of patients with a subarachnoid hemorrhage?
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they complain of the "worst headache of my life", CSF is yellowish or bloody
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what characterizes communicating hydrocephalus?
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impaired absorption of CSF at the arachnoid granulations
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what characterizes non-communicating hydrocephalus?
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blockage of one of the foramen that connect all the ventricles
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What are some consequences of Sturg-Weber syndrome?
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glaucoma, seizures, hemiparesis, mental retardation
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What are some consequences of tuberous sclerosis?
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hamartomas in CNS, skin, and other tumors in other organ systems
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What are some consequences of Neurofibromatosis?
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cafe-au-lait spots, nodules in the iris, neurofirbomas in skin
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What are some consequences of von-Hippel Lindau disease?
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autosomal dominant, hemangiomas in skin and organs, hemangioblastomas in retina, brain
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Most adult brain tumors are supratentorial, and most children brain tumors are subtentorial. Or is it the other way around?
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No, that's right. Adult=supratentorial, child=subtentorial
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What characterizes a glioblastoma multiforme?
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non-encapsulated, aggressive, necrosis and hemorrhage. Most common adult brain tumor.
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What characterizes a meningioma?
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arises from arachnoid cells. Well encapsulated, resectable. 2nd most common adult brain tumor
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What characterizes a Schwannoma?
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arises from schwann cells in CN7, in the ear. resectable. 3rd most common adult brain tumor.
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what characterizes an oligodendroglioma?
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calcified, "fried egg" cell appearance. Occurs in frontal lobes in adults. Rare.
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What characterizes a pituitary adenoma?
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tumor in pituitary, usually a prolactinoma. Mass effects cause visual disturbances
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What characterizes a pilocytic astrocytoma?
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well-encapsulated, resectable. Good outcomes. Most common childhood brain tumor. Supratentorial
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What characterizes a medulloblastoma?
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primitive neuroectodermal tumor (PNET). very aggressive, found in the cerebellum in children. Can cause hydrocephalus
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What characterizes an ependymoma?
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grows from ependymal cells in the 4th ventricle in children. Bad outcomes. Causes hydrocephalus
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What characterizes a hemangioblastoma?
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Highly vascular tumors usually in cerebellums of children. Associated with von-Hippel-Lindau disease
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What characterizes a craniopharyngioma?
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remnant of Rathke's pouch gets calcifed, can cause vision problems. Happens in children, mistaken for pituitary adenomas
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What is an Arnold-Chiari malformation?
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Small posterior fossa, cerebellum and medulla are smooshed downwards
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What is a Chiari I malformation?
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low lying cerebellum obstructs CSF outflow and compresses the medulla. correctable with surgery
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What is a Chiari II malformation?
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cerebellar vermis and medulla descend completely through foramen magnum. Fatal
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What is a Dandy-Walker malformation?
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large posterior fossa, but no cerebellum. There's a big cyst in its place
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Lesion of the upper motor neurons of the facial nerve result in what?
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contralateral paralysis of the lower face only
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Lesions of the lower motor neurons of the facial nerve result in what?
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ipsilateral paralysis of both the upper and lower face
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What characterizes Bell's palsy?
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destruction of the facial nucleus. Results in ipsilateral lower face paralysis, inability to close the eye on the affected side
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What are some disease processes that have Bell's Palsy as a complication?
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AIDS, Lyme Disease, Sarcoidosis, Tumors, Diabetes
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What drug acts at the mu opioid receptor?
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morphine
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What drug acts at the delta opioid receptor?
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enkephalin
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What drug acts at the kappa opioid receptor?
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dynorphin?
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What are the common toxicities of opioid drugs?
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respiratory depression, pinpoint pupils, CNS depression
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What opioid drugs are used to treat GI diarrhea?
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loperamide and diphenoxylate
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how does phenytoin work?
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blocks Na+ channels in neurons
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how does carbamazepine work?
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blocks Na+ channels in neurons
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how does lamotrigine work?
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blocks voltage-gated Na+ channels in neurons
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How does gabapentin work?
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increases GABA release
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how does topiramide work?
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blocks Na+ channels in neurons, increases GABA release
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How does phenobarbital work?
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Increases action of GABA
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how does valproic acid work?
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inactivates Na+ channels in neurons, increases GABA concentration
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How does ethosuximide work?
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blocks Ca++ channels in the thalamus
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how do benzodiazepines work?
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Increase the action of GABA
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What is Stephens-Johnson Syndrome?
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malaie and fever, followed by red macules that progress to necrosis and slough off
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What drugs has Stevens-Johnsons Syndrome as a side effect?
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ethosuximide and lamotrigine
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What are some side-effects of phenytoin?
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nystagmus, diplopia, ataxia, gingival hyperplasia, hirsutism, megaloblastic anemia, induces cyp450
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What are some side effects of valproic acid?
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fatal hepatoxicity, neural tube defects in fetuses, weight gain
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What are some side effects of topiramate?
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mental dullness, kidney stones, weight loss
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what are some side-effects of carbamazepine?
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diplopia, ataxia, agranulocytosis, aplastic anemia, liver toxicity, induces cyp450
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anesthestics with low solubility in the blood have what kind of pharmacokinetics?
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rapid onset of anesthesia, rapid recovery times
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anesthetics with high solubility in lipids have what kind of pharmacokinetics?
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high potency, you need a smaller Minimum Alveolar Concentration (MAC) to have the same effect
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What are some side effects of halothane?
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hepatotoxicity, malignant hyperthermia
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What is propofol used for?
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general anesthetic used for short procedures, few side effects
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What are some side effects of ketamine?
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cardiovascular stimulant, disorientation, bad dreams, increased cerebral blood flow
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Which local anesthetics are esters?
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procain, cocaine, tetracaine
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Which local anesthetics are amides?
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any of the -caines with two I's in the name
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How do local anesthetics work?
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physically block Na+ channels from the inside. Preferentially deactivate the most active channels
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What is the order of sensation loss when given a local anesthetic, from first to last?
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pain, temperature, touch, pressure
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local anesthetics block what size and type of nerve fiber first?
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small/myelinated fibers are blocked first, large/unmyelinated fibers last. Size is more important than myelination
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What drug is a depolarizing paralytic?
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succinylcholine
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What drugs are non-depolarizing paralytics?
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any drug with -cura- in the name somewhere
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What are some side-effects of succinylcholine?
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hypercalcemia, hyperkalemia
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How do you treat malignant hypertension?
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dantrolene
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What anti-parkinsons drug activates dopamine receptors?
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bromocriptine
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What anti-parkinson drugs increases dopamine release?
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amantadine, L-dopa/carbidopa
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What anti-parkinson drug prevents dopamine breakdown?
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selegiline, entacapone
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What anti-parkinson drug suppresses excess cholinergic activity?
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benztropine
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what are some side-effects of L-dopa?
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arrythmia, diskinesia
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What is sumatriptan? what conditions does it treat?
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serotonin agonist. treats migraines and cluster headaches
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What are some side-effects of sumatriptan?
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coronary vasospasm, hypertensive emergencies
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What neurotransmitters are affected in people with anxiety?
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increased NE
decreased GABA and 5HT |
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What neurotransmitters are affected in people with depression?
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decreased NE and 5HT
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What neurotransmitters are affected in people with parkinsons' disease?
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increased Ach
decreased dopamine |
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What neurotransmitters are affected in people with Alzheimer's disease?
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decreased Ach
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What is is called when a person can't locate their own body parts?
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autotopagnosia
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What is it called when someone is unaware that they are ill?
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anosognosia
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What are the positive symptoms of schizophrenia?
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delusions, hallucinations, disorganized thought patterns, disorganizaed behavior
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What are the negative symptoms of schizophrenia?
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flat affect, withdrawal, lack of speech or thought
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How does depression affect a person's sleep?
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repeated nighttime wakings, early morning wakening
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What is Munchausen's syndrome?
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chronic faking of symptoms in order to get medical attention
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What are the 3 Cluster A personality disorders?
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paranoid, schizoid, schizotypal
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What are the 4 Cluster B personality disorders?
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antisocial, borderline, histrionic, narcissistic
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What are the 3 Cluster C personality disorders?
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avoidant, obsessive-compulsive, dependant
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What is the difference between schizoid and schizotypal personality disorders?
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schizoid=social withdrawal, limited emotions. Engineer.
schizotypal=odd beliefs, weird appearance. Goth chick. |
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What is the difference between repression and suppression?
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repression=involuntary withholding of an idea from conscious thought.
suppression=same, but the process is voluntary; you are aware of it |
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How do the normal antipsychotic medicines work?
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block dopamine receptors
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What are some side-effects of normal anti-psychotic medicines?
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extrapyramidal effects, neuroleptic maligant syndrome, tardive dyskinesia
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How do the atypical anti-psychotics work?
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block serotonin and dopamine receptors
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What are the common atypical antipsychotics?
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clozapine, olanzapine, risperidone
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What is the biggest side-effect of clozapine?
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agranulocytosis
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What are the side-effects of lithium?
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tremors, diabetes insipidus, hypothyroidism, pregnancy problems
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How does Buspirone work? What do you use it for?
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stimulates serotonin receptors. Treats depression
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What are the common SSRI's? What are some side effects?
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fluoxetine, sertraline, citoprolam. Gi distress and sexual dysfunction
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What are some common tricyclic antidepressants?
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anything ending with -tryptyline or -pramine
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How do tricyclic antidepressants work?
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block reuptake of NE and 5HT
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What are the side effects of tricyclic antidepressants?
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tachycardia, urinary retention, convulsions, cardiotoxicity, coma
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