BBEOYS2 Flashcards
Which drug used to treat Huntingdons Disease works by the mechanism of action depicted by A? [1]
Tetrabenazine
acts primarily as a reversible high-affinity inhibitor of mono-amine uptake into granular vesicles of presynaptic neurons by binding selectively to VMAT-2
Which treatment used in PD is good at managing tremors
Haloperidol
Ritotigone
L-DOPA
Orphenadrine
Which treatment used in PD is good at managing tremors
Haloperidol
Ritotigone
L-DOPA
Orphenadrine: anticholinergic
[] is defined as that part of the PFC in which saccades can be elicited
Superior colliculi
Inferior colliculi
Frontal eye fields
Supplementary eye field
[] is defined as that part of the PFC in which saccades can be elicited
Superior colliculi
Inferior colliculi
Frontal eye fields
Supplementary eye field
The tectospinal tract orginates at the
Superior colliculi
Inferior colliculi
Frontal eye fields
Supplementary eye field
The tectospinal tract orginates at the
Superior colliculi
Inferior colliculi
Frontal eye fields
Supplementary eye field
Damage to which of the following would cause someone to not be able to inhibit a response to a stimulus
A
B
C
Damage to which of the following would cause someone to not be able to inhibit a response to a stimulus
A: dorsolateral pre-frontal cortex
B
C
Carbidopa and benserazide inhibit which enzymes
Monoamine oxidase
COMT
Decarboxylase
Amylase
Carbidopa and benserazide inhibit which enzymes
Monoamine oxidase
COMT
Decarboxylase: stop conversion of L-DOPA - dopamine
Amylase
If you were sitting in a quiet room and all of a sudden heard a noise to your right, you would subconsciously turn your head in that direction and orient your eyes towards the direction of the sound, attempting to find the source. Which spinal tract would be responsible for this? [1]
Tectospinal tract
Which spinal tract provides drive to the respiration via the phrenic nerve?
Rubrospinal
Lateral vestibulospinal
Recticulospinal
Cortciospinal
Coticobulbar
Which spinal tract provides drive to the respiration via the phrenic nerve?
Recticulospinal
Pharmacological management of Parkinson’s disease
Name two drugs that can combined with L-DOPA (aka levodopa) that means it doesn’t get metabolised to dopamine outside the BBB [2]
What is their MOA? [1]
L-DOPA (levodopa) & carbidopa or benserazide
carbidopa, benserazide are decaboxylase inhibitors: allows L-DOPA to pass BBB where it can then be converted to dopamine
Pharmacological management of Parkinson’s disease
Name 3 dopminergic agonists and describe their MOA
Dopamine agonists:
* ropinirole
* pramipexole
* rotigotine (in BB PBL; transdermal patch)
Dopamine agonists act directly on the dopamine receptors and mimic dopamine’s effect
Which of the following dopamine agonists can be used as a transdermal patch?
bromocriptine,
pramipexole
ropinirole
rotigotine
Apomorphine
Which of the following dopamine agonists can be used as a transdermal patch?
bromocriptine,
pramipexole
ropinirole
rotigotine
Apomorphine
Which of the following dopamine agonists can be used as an infusion for major motor fluctuations?
bromocriptine,
pramipexole
ropinirole
rotigotine
Apomorphine
Which of the following dopamine agonists can be used as an infusion for major motor fluctuations?
bromocriptine,
pramipexole
ropinirole
rotigotine
Apomorphine
Pharmacological management of Parkinson’s disease
Name three drugs that are monoamine oxidase inhibitors [3]
Describe their MoA [1]
- rasagiline
- selegiline (in PBL)
- safinamide
MAO-B inhibitors stop Monoamine oxidase type B breaking down dopamine into DOPAC or homovanillic acid
What is the MoA of COMT inhibitors? [1]
Explain why [1]
Which drugs are they used in conjunction with? [1]
COMT is an enzyme involved in the breakdown of dopamine (DOPAC –> homovanillic acid) and hence may be used as an adjunct to levodopa therapy
Pharmacological management of Parkinson’s disease
Name 2 COMT inhibitors [2]
entacapone
tolcapone
Pharmacological management of Parkinson’s disease
Name three anticholinergic compounds [3]
Which symtpom are they particularly good for treating? [1]
orphenadrine, procyclidine, trihexyphenidyl
Block tremors (as block muscarinic receptors on muscles) but also cause dry mouth and constipation
Pharmacological management of Parkinson’s disease
What is the MoA of Amantadine? [3]
inhibits dopamine reuptake, increases dopamine release, also weak antagonist at NMDA glutamate receptors
Pharmacological management of PD:
Other treatment approaches
Name two cell based approaches that can use to treat PD [2]
- Striatal graft of embryonic mesencephalic cells: intrastriatal transplant of foetal nigral cells
- Systemic administration of mesenchymal stem cells: Improvement following repeated intravenous injection of adipose tissue-derived cells
Surgical approaches in Parkinson’s disease
Describe the surgical approaches to PD treatment [4]
Electrode stimulation of the subthalamic nucleus
Thalamotomy
Pallidotomy
deep brain stimulation for people with advanced Parkinson’s disease whose symptoms are not adequately controlled by optimised pharmacological therapy
Brain areas involved decision making & movement planning:
Which area of the brain is where conscious intentions are formed and we become aware of motor movement? [1]
Name another key function of this area? [1]
The posterior parietal cortex
Also provides a representation of the body and how it is situated in space
Broadmann areas 39 & 40
Prefrontal cortex:
Dorsolateral prefrontal cortex
What is this region of the pre-frontal cortex involved with? [3]
Planning of goal-directed behaviours AND simulating the consequences of plans
Initiating, inhibiting and swtiching executive behaviour: input to the basal ganglia about stop / start
Involved with:
Problem-solving
Goal-driven attention
Planning
Decision making
Working memory
dorsolateral prefrontal cortex:
Lesions in Brodmann area 46 affects which functions? [1]
Attention and working memory: affects ability to inhibit a response to a stimulus
What is the role of the medial prefrontal cortex ?
Guide and monitor actions that are internally guided according to preferences and goals:
I.e. it modulates the degrees of cognitive control need to keep in behaviour in line with the goal
Prefrontal cortex
What is the role of the orbitofrontal cortex? [1]
Representation of value for rewards and punishers (what is good for you / bad for you)
supplementory motor area:
Location:
Broadmann area? [1]
Lobe? [1]
Role? [2]
Location:
medial part of BA 6; frontal cortex
Role:
* Orgnaises actions that are internally guide according to preferences and goals: choosing objects
* Determines response threshold to initiate movement - the urgency of movement
* Response to start or stop a movement (interconnects to basal ganglia)
e.g which object to choose (in alignment with goals)
plan sequence of learned actions - e.g. playing piano
Label the orange, purple, green and grey barts of the brain
Purple: premotor
orange: dorsolateral prefrontal
green: orbitofrontal
grey: FEF
Extrapyramidal tracts:
Describe the course of the lateral vestibulospinal tract [1]
Which type of muscles does it synapse onto? [1]
Fibres descend ipsilaterally though the anterior funiculus of the same side of the spinal cord, synapsing on the extensor antigravity motor neurons: help maintain upright and balanced posture.
Describe the function and path of the rubrospinal tract [2]
Function: Controls muscle tone in flexor muscle groups; Inhibits extensor tone
Path:
- Arises from the red nucleus in the brainstem
- crosses at medulla
- terminates primarily in the cervical and thoracic portions of the spinal cord
