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Year 2 BB > Overview 3 > Flashcards

Overview 3 Flashcards

1
Q

Most common form of dementia is?

A

AD

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2
Q

Four non-modifiable risk factors for dementia are?

A

Age
Genetics
Family history
Down syndrome

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3
Q

Greatest risk factor for onset of dementia is?

A

Age

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4
Q

Four modifiable risk factors leading to dementia?

A

Vascular - cholesterol, hypertension
Cognitive inactivity
Environment - head injury
Depression

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5
Q

Two protein components that are characteristic of AD are?

A

Beta-amyloid plaques

Neurofibrillary tangles of protein Tau

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6
Q

Significant loss of what cells occurs in the brain of someone with AD?

A

Loss of cholinergic cells

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7
Q

Genes causing early onset AD? x3

A

APP
PSEN1
PSEN2

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8
Q

APP is on which chromosome?

A

21

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9
Q

PSEN1 is on which chromosome?

A

4

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10
Q

PSEN2 is on which chromosome?

A

1

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11
Q

Why are those with Downs syndrome more susceptible to the development of AD?

A

Three lots of chromosome 21 - more chance of mutation of APP gene

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12
Q

Function of PSEN proteins?

A

Cleavage of APP

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13
Q

APP stands for?

A

Amyloid precursor protein

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14
Q

APP expressed in which cells? x4

A

Neurones
Glial cells
Endothelial cells
Smooth muscle cells

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15
Q

Number of mutations in APP that are possible?

A

29

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16
Q

APP mutation that is protective of AD is?

A

A673T

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17
Q

PSEN1 and PSEN2 are subunits of what?

A

Gamma-secretase

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18
Q

PSEN1 and PSEN2 - which is common and which is rare?

A

PSEN1 - common

PSEN2 - rare

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19
Q

What is the type of mutation that occurs in PSEN2?

A

Missense

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20
Q

What are the three different secretase enzymes that can cleave APP protein?

A

Alpha-secretase
Beta-secretase
Gamma-secretase

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21
Q

Two possible amyloid pathways are?

A

Amyloidogenic

Non-amyloidogenic

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22
Q

Which of the amyloidogenic pathways are pathological?

A

Amyloidogenic

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23
Q

Secretase enzymes involved in the non-amyloidogenic pathway is? x2

A

Alpha-secretase

Gamma-secretase

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24
Q

Secretase enzymes involved in the amyloidogenic pathway is? x2

A

Beta-secretase

Gamma-secretase

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25
Q

Toxic species generated from the amyloidogenic pathway is?

A

Oligomers

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26
Q

Why are oligomers dangerous?

A

These are neurotoxic

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27
Q

Inflammatory response occurs in AD - what cells are activated?

A

Microglia

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28
Q

Activated microglia release what component?

A

TNF-alpha

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29
Q

Why are oligomers toxic?

A

Can signal to normal beta-amyloid protein to misfold itself and adopt the mutated form of beta-amyloid that is formed from the amyloidogenic pathway

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30
Q

Gene resulting in development of late onset AD is?

A

Apolipoprotein E

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31
Q

Apolopoprotein E found on which chromosome?

A

19

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32
Q

Early onset AD occurs at what age?

A

40-50 years

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33
Q

Late onset AD occurs at what age?

A

60+ years

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34
Q

Three isoforms of ApoE are?

A

ApoE2
ApoE3
ApoE4

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35
Q

Isoform of ApoE causing development of late onset AD is?

A

ApoE4

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36
Q

Isoform of ApoE that is protective to the development of AD is?

A

ApoE2

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37
Q

Tangles of what form in AD?

A

Neurofibrillary tangles of the protein Tau

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38
Q

Normal function of Tau is?

A

Stabilisation of microtubules to ensure neurones receive the correct components e.g. ATP required for their function

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39
Q

Consequence of hyperphosphorylation of Tau?

A

Causes Tau to dissociate off of the microtubules

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40
Q

What is the gene that encodes the protein Tau?

A

MAPT

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41
Q

Are mutations in the MAPT gene associated with the development of AD?

A

No

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42
Q

Looking at CSF - what will be seen in someone with AD?

A

Less amyloid present in the CSF

Amyloid is accumulating in the brain as plaques

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43
Q

MRI scan for diagnosis for AD will show?

A

Neuronal loss - cortex and hippocampus

Enlarged ventricles

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44
Q

Loss of what neurones in AD?

A

Cholinergic

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45
Q

How can the cholinergic effects of AD be treated?

A

Administer acetylcholinesterase inhibitors

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46
Q

Name three acetylcholinesterase inhibitors

A

Donepezil
Rivastigmine
Galantamine

Don’t Rivers Galantamine

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47
Q

Contraindication of AChE inhibitors in patient - what drug might be used?

A

NMDA receptor antagonists

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48
Q

Indication for use of AChE inhibitors vs. NMDA receptor antagonists?

A

AChE inhibitors - mild to moderate AD

NMDA receptor antagonists - moderate to late disease

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49
Q

NMDA receptor antagonist main one used is?

A

Memantine

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50
Q

Why are NMDA receptor antagonists used to treat AD?

A

Some form of excitotoxicity occurs in AD and this prevents htis

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51
Q

Nucleus that controls the sleep wake cycle i.e. circadian rhythm is?

A

Suprachiasmatic nucleus

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52
Q

Suprachiasmatic nucleus is located where?

A

Hypothalamus

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53
Q

Two neuronal systems involved in wakefulness are?

A

Cholinergic systems

Monoaminergic systems

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54
Q

Neuronal system involved in sleep is?

A

GABA

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55
Q

One sleep cycle lasts how long?

A

90 minutes

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56
Q

What are the three stages of the sleep-wake cycle?

A

REM
NMREM
SWS

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57
Q

What is SWS in the sleep-wake cycle?

A

Slow wave sleep

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58
Q

Function of sleep on memories?

A

Consolidation of memories

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59
Q

Three forms of insomnia are?

A

Transient - jet lag
Short term - illness
Chronic - underlying cause

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60
Q

Two drugs used to treat insomnia are?

A

Benzodiazepines

Z-drugs

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61
Q

Main difference between benzodiazepines and z-drugs?

A

Benzodiazepines - long half life - not good for short period of sleep
Z-drugs - short half life

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62
Q

Benzodiazepines/z-drugs - which is more popular for treatment of insomnia?

A

Z-drugs (short half life)

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63
Q

Unwanted side effects of benzodiazepines? x5

A 
Change in sleep patterns
Daytime sedation
Insomnia
Tolerance
Dependence
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64
Q

Why should prolonged usage of hypnotics be avoided?

A

Dependence

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65
Q

Treatment for chronic insomnia is?

A

CBT

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66
Q

What is orexin?

A

Peptide

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67
Q

Where is orexin produced?

A

Hypothalamus

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68
Q

Two forms of orexin?

A

A and B

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69
Q

Orexin is also known as?

A

Hypocretin (1 and 2)

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70
Q

Three functions of orexin?

A

Arousal regulation
Appetite regulation
Wakefulness regulation

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71
Q

Deficiency in orexins results in?

A

Narcolepsy

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72
Q

What is narcolepsy?

A

Excess sleepiness - falling asleep in the day

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73
Q

Anxiety disorders are more common in m or f?

A

Female

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74
Q

Two neurotransmitters involved in anxiety are?

A

GABA

Monoamines

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75
Q

Key region in the brain related to anxiety?

A

Amygdala

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76
Q

Five genes associated with anxiety development?

A 
COMT
CCK
Adenosine A2
MAOa
5-HT2
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77
Q

Anxiolytic group that is no longer used is?

A

Barbituates

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78
Q

Four groups of anxiolytics?

A

Benzodiazepines
5-HT1a agonists
Beta-adrenoreceptor antagonists
SSRIs

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79
Q

Function of barbituates?

A

Very strong CNS depressants

80
Q

Four adverse effects o barbituates?

A

Major drug dependence
Tolerance
Fatal in overdose
Withdrawal syndrom

81
Q

Key target of most anxiolytic drugs is?

A

GABAergic synapse

82
Q

Function of benzodiazepines at GABAa receptor?

A

Positive allosteric modulators - causes the channel to open more frequently

83
Q

Function of barbituates at GABAa receptor?

A

Positive allosteric modulators - causes the channel to open for longer

84
Q

Function of benzodiazepines vs. barbituates?

A

Benzo - increase frequency

Barbituate - increase duration

85
Q

Drug that should be given in a benzodiazepine overdose is?

A

Flumazenil

86
Q

Function of flumazenil?

A

Antagonist at benzodiazepine receptor

87
Q

Flumazenil - short or long half life?

A

Short

88
Q

What is buspirone?

A

Anxiolytic

89
Q

Five issues of benzodiazepine use in the elderly?

A 
Psychomotor impairment
Increased risk of falls
Daytime drowsiness
Intoxication
Amnesia
Depression
90
Q

Z drugs bind to which subunits of GABAa receptor?

A

Alpha subunit

91
Q

Z drugs bind to which subunits of GABAa receptor for hypnotic purpose?

A

alpha-1

92
Q

Z drugs bind to which subunits of GABAa receptor for anxiolytic purpose?

A

alpha-3

93
Q

Long term memory involves what region of the brain?

A

Hippocampus

94
Q

Two types of long term memory are?

A

Declarative/explicit

Non-declarative/implicit

95
Q

Declarative memory is?

A

Conscious and intentional memory of factual information and experiences

96
Q

Non-declarative memory is?

A

Memory acquired unconsciously e.g. skills/behaviours

97
Q

Two types of declarative memory?

A

Episodic memory

Semantic memory

98
Q

Episodic memory is?

A

Form of declarative memory - going back in time to remember personal events

99
Q

Semantic memory is?

A

Recalling general facts and facts about the world e.g. 2+2=?

100
Q

Is short term memory involved with ‘learning and memory’?

A

No

101
Q

Spatial memory is?

A

Memory responsible fo recording information based on one’s environment and spatial orietnation

102
Q

Spatial memory involves what part of teh brain?

A

Hippocampus

103
Q

Three types of amnesia?

A

Anterograde
Retrograde
Dissociative

104
Q

Amnesia is?

A

Partial or complete loss of memory

105
Q

Anterograde amnesia is?

A

Cannot transfer new events into long term memory (Henry M)

106
Q

Retrograde amnesia is?

A

Cannot recall events that occurred prior to onset of amnesia

107
Q

Dissociative amnesia is?

A

Blocking out critical personal information of a traumatic/stressful nature

108
Q

Long term potentiation is?

A

Strengthening of synapses due to repetition

109
Q

Receptors involved in LTP?

A

NMDA glutamate

110
Q

Long term depression is?

A

Reduction in strength of synapses due to lack of repetition

111
Q

Definition of consciousness is?

A

Ability of an individual to react appropriately to a stimuli in the outside world

112
Q

Consciousness measured via?

A

Glasgow Coma scale

113
Q

Part of the brain controlling consciousness is?

A

Cerebral cortex

114
Q

EEG shows what?

A

Activity of neurones in the cerebral cortex

115
Q

EEG of someone in coma?

A

No electrical activity

116
Q

EEG of someone in sleep?

A

In certain stages - EEG represents that of someone awake and at some points, represents that of someone that is unconscious

117
Q

Normal sleep is known as which stage of sleep?

A

Slow wave sleep

118
Q

Function of slow wave sleep? x3

A

Increased growth and rejuvenation of the immune system
of the nervous system
of skeletal and muscular systems

REST AND REPAIR

119
Q

What hormone is secreted during slow wave sleep? x2

A

Growth hormone

Leptin

120
Q

Cortisol levels during sleep?

A

Decreased

121
Q

Blood pressure during normal/slow wave sleep?

A

Reduced - nocturnal dipping

122
Q

Lack/diminished nocturnal dipping indicates what?

A

Predictor of cardiovascular disease

123
Q

How many stages are there in sleep?

A

4 + 1 stage of REM

124
Q

Stages 1-4 repeat how often?

A

Every 90 minutes

125
Q

EEG of REM sleep represents?

A

EEG of REM is similar to that of someone that is awake

126
Q

More synchronisation on EEG represents?

A

Less conscious the individual

127
Q

Key control centre of sleep located where?

A

Reticular formation of the PONS

128
Q

Reticular formation of the pons is regulated by what?

A

Hypothalamus

129
Q

Effect of ghrelin on sleep?

A

Inhibitory action on sleep

130
Q

Effect of CCK on sleep?

A

Increases sleepiness

131
Q

Effect of adenosine on sleep?

A

High adenosine induces sleep

132
Q

Effect of caffeine on adenosine?

A

Caffeine - antagonist at A1 adenosine receptor

133
Q

Reticular formation located where?

A

Pons

134
Q

Why does caffeine effect sleep?

A

Adenosine - induces sleep

Caffeine - antagonist of adenosine at A1 receptor

135
Q

Histaminergic neurones located in which nucleus?

A

Tubermamillary nucleus

136
Q

Histamine neurones during wake/sleep?

A

Active during wake

Silent during sleep

137
Q

Effect of antihistamines on wake/sleep?

A

Cause drowsiness - histamine is silent during sleep

138
Q

Diurnal rhythms controlled by which nucleus?

A

Suprachiasmatic

139
Q

Reticular formation is key control of what?

A

Sleep

140
Q

Cause of narcolepsy?

A

Lack of orexins

141
Q

Orexins are found where in the brain mainly?

A

Posterior hypothalamus

142
Q

Orexins cause release of which four neurotransmitters?

A

Acetylcholine
Noradrenaline
Serotonin
Dopamine

143
Q

Pedunculopontine nuclei neurones project to where?

A

Thalamus

144
Q

Nucleus basalis/basal forebrain nucleus contains neurones of which neurotransmitter?

A

Cholinergic neurons

145
Q

What percentage of AD patients have sleep disorders?

A

70%

146
Q

Serotonin - increase or decrease during sleep?

A

Decrease

147
Q

Noradrenaline - increase or decrease during sleep?

A

Decrease

148
Q

Acetylcholine - increase or decrease during sleep?

A

Increase

149
Q

Acetylcholine activates what two areas of the brain?

A

Thalamus

Cortex

150
Q

Lack of memory of dreams is due to lack of production of which neurotransmitter?

A

Noradrenaline

151
Q

Amphetamine/cocaine - prevents sleep due to the production of which neurotransmitter?

A

Dopamine

152
Q

SSRis interfere with which stage of sleep?

A

REM sleep

153
Q

TCAs promote sleep how?

A

Block histamine H1 receptors

154
Q

Function of REM sleep? x2

A

Memory consolidation

Removal of junk and defragmentation of memories

155
Q

Motor cortex - active or inactive during sleep?

A

Active

156
Q

What normally prevents e.g. sleep walking during seep?

A

Inactivation of LMNs

157
Q

Inactivation of LMNs during sleep is mediated via which two neurotransmitters?

A

Serotonin

Dopamine

158
Q

Unconditioned stimulus is?

A

Stimulus that already elicits a response e.g. food

159
Q

Unconditioned response is?

A

A response that does not need to be learned e.g. salivating to food

160
Q

Conditioned stimulus is?

A

Previously neutral stimulus which the individual now responds to e.g. bell

161
Q

Conditioned response?

A

Learned response e.g. salivating to sound of a bell

162
Q

What is the Garcia effect?

A

Avoid eating certain food/drink due to past unpleasant experience

163
Q

Theory of tolerance (in classical conditioning) is?

A

Cessation of conditioned stimulus intake does not break the association of the conditioned response from the conditioned stimulus

164
Q

What is ‘flooding’?

A

Place client into a situation which is anxiety inducing but where no harm can come to them

165
Q

Operant conditioning - what is fixed ratio reinforcement?

A

Positive/negative reinforcement given after every response

166
Q

Operant conditioning - what is variable ratio reinforcement?

A

Reinforcement is not stable and is randomised - most effective

167
Q

Mortality rate of severe head injury?

A

25%

168
Q

Munroe-kelly doctorine states what?

A

Fixed cranial compartment (skull) - if one of the constituents increase then there is a rise in ICP

169
Q

Three constituents stated by the Munro-kelly doctorine are?

A

Brain
CSF
Blood

170
Q

Equation of ICP and cerebral perfusion?

A

CPP = MAP - ICP

171
Q

Effect of increased ICP on cerebral perfusion?

A

Cerebral perfusion will decrease

172
Q

Uncus is part of what lobe?

A

Temporal lobe

173
Q

Two layers of the dura mater are?

A

Periosteal layer

Meningeal layer

174
Q

High ICP - good or poor outcome?

A

Poor

175
Q

How is the pain tolerance ratio calculated?

A

Time in trial 1 (experiment) / time in the baseline (control)

176
Q

How is the pain intensity ratio calculated?

A

Mean score in trial 1 / mean score in the baseline

177
Q

What region of the brain is specifically effected in MS?

A

Medial longitudinal fasciculus (MLF)

178
Q

Region responsible for memory relay/transmission prior to storage is?

A

Fornix

179
Q

Region responsible for memory storage is?

A

Hippocampus

180
Q

Region responsible for memory formation is?

A

Cingulate cortex

181
Q

Middle meningeal artery enters the cranial cavity via which foramen?

A

Foramen spinosum

182
Q

Uncal herniation occurs where?

A

Lateral to brainstem

183
Q

Tonsillar herniation occurs where?

A

Posterior - by the cerebellar tonsils

184
Q

Subfalcine herniation occurs where?

A

Posterior by the cerebellum

185
Q

What passes through the cribriform plate?

A

CNI

186
Q

What passes through the optic canal?

A

CNII

187
Q

What passes through the superior orbital fissure? x4

A

CN III
CN IV
CNV1
CNVI

188
Q

What passes through the sella turcica?

A

Hypophysis

189
Q

What passes through the foramen rotundum?

A

CNV2

190
Q

What passes through the foramen ovale?

A

CNV3

191
Q

What passes through the foramen lacerum?

A

Petrosal nerve

192
Q

What passes through the foramen spinosum?

A

Middle meningeal artery

193
Q

What passes through the internal auditory meatus? x2

A

CNVII

CNVIII

194
Q

What passes through the jugular foramen? x4

A

Internal jugular vein
CNIX
CNX
CNXI

195
Q

What passes through the hypoglossal canal?

A

CNXII

Year 2 BB (36 decks)

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