CNS Disorders

Question 1

Which membrane in the brain are efflux transporters found?

Answer 1

Apical membrane

Question 2

What is the role of tight junctions in the brain?

Answer 2

Regulate what passes between the brain

Question 3

Efflux transporters encourage drug delivery to the brain. True or false?

Answer 3

False - they hinder drug delivery

Question 4

How does someone get a stroke?

Answer 4

Blood vessel is occluded e.g. due to a clot or plaque fragment. This leads to a lack of nutrients and oxygen, resulting in cell death

Question 5

What are the two areas of lesions?

Answer 5

umbra

penumbra

Question 6

Is damage to the umbra reversible?

Answer 6

No - it is irreversible

Question 7

Is damage to the penumbra reversible?

Answer 7

Yes - damage occurs however there is still potential recovery of the neurone

Question 8

What is a tissue plasminogen activator (tPA)?

Answer 8

A protein found on endothelial cells - it is used in medicines to dissolve blood clots and treat stroke

Question 9

What is an example of a tPA?

Answer 9

alteplase

Question 10

What is the NICE recommendation of treating stroke with tPA?

Answer 10

ASAP and within 4.5 hours of symptom onset

Question 11

What are the two types of stroke and which one is more common?

Answer 11

Ischaemic - more common

Haemorrhagic - less common - death is likely

Question 12

What are the risk factors for stroke?

Answer 12

Hypertension
Smoking
Obesity
Poor diet, lack of exercise 
Diabetes

Question 13

Parkinson’s disease is idopathic. What is meant by that?

Answer 13

Don’t know what causes the disease

Question 14

What happens in Parkinson’s disease?

Answer 14

Death of dopaminergic neurones - leads to lack of dopamine

Question 15

What is the substantia nigra?

Answer 15

Part of the basal ganglia in the brain - important in reward and movement

Question 16

Those that suffer from Parkinson’s disease experience tremors. What are they?

Answer 16

Uncontrolled movement

Question 17

How can Parkinson’s disease be treated and what is an example of a drug that is used?

Answer 17

Replenish dopamine - Levodopa

Question 18

What are the two forms of Alzheimer’s disease?

Answer 18

Early onset

Late onset

Question 19

What age group tend to suffer from early onset Alzheimer’s disease?

Answer 19

Under 65 y/o (only 5% fall into this category)

Question 20

What is Alzheimer’s disease?

Answer 20

Loss of brain material and volume

Physical reduction in brain size and activity

Question 21

In patients with Alzheimer’s disease amyloid B aggregates to form _________ which aggregate to form plaques in the brain

Answer 21

oligomers

Question 22

How many amino acids does the insoluble form of amyloid B have?

Answer 22

42

Question 23

Alzheimer’s disease can be treated with drugs. True or false?

Answer 23

False - no effective treatment - treat symptoms

Question 24

What class of drugs is used to treat symptoms of Alzheimer’s disease?

Answer 24

Acetylcholinesterase inhibitors

Question 25

What happens to serotonin in someone who has depression?

Answer 25

It’s released into the synaptic cleft and instead of being broken down by an enzyme, it is transported back to the presynaptic neurone

Question 26

What is the therapeutic target for depression?

Answer 26

Serotonin transporter

Question 27

What class of drugs is used to treat depression?

Answer 27

Selective Serotonin Reuptake Inhibitors (SSRI)

Question 28

What do SSRIs do?

Answer 28

Maintain serotonin in the synaptic cleft

Question 29

What is astrocytoma?

Answer 29

Primary type of brain tumour

Question 30

How can astrocytoma be treated?

Answer 30

Radiotherapy
Surgery and carmustine implants
Surgery and temozolimide

Question 31

What is oligodendroglioma?

Answer 31

Cancer of the oligodendrocytes (which produce myelin)

Question 32

What is ependymoma?

Answer 32

Cancer of the ependymal cells

Question 33

Why is it difficult to deliver drugs to the brain?

Answer 33

BBB

Can’t increase dose due to toxicity issues