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BMB Test 1 > B7-010 CBCL Syncope > Flashcards

B7-010 CBCL Syncope Flashcards

1
Q

predominately thoracolumbar outputs

A

sympathetic system

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2
Q

predominately craniosacral outputs

A

parasympathetic nervous sytem

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3
Q

peripheral blood vessels have exclusively […] inputs

A

sympathetic

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4
Q

has long preganglionic neurons

A

parasympathetic

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5
Q

has short preganglionic neurons

A

sympathetic

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6
Q

[…] outputs most strongly drive changes in MAP

A

sympathetic

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7
Q

how does the SNS compensate for low MAP [2]

A

increase peripheral resistance
tachycardia

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8
Q

how does the PNS compensate for high MAP

A

bradycardia

**this effect is very limited compared to SNS effects, SNS is main driver of MAP

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9
Q

stimulates all preganglionic efferent autonomic fibers

A

ACh

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10
Q

stimulates most parasympathetic postganglionic and a few sympathetic postganglionic (sweat glands) fibers

A

ACh

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11
Q

neurotransmitter that stimulates postganglionic neurons in GI and erectile tissue

A

nitric oxide

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12
Q

stimulates sympathetic fibers of thermoregulatory sweat glands

A

ACh

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13
Q

stimulates most postganglionic sympathetic fibers

A

Norepinephrine

**excludes thermoregulatory sweat glands

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14
Q

epinephrine and norepinephrine are released from

A

adrenal glands

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15
Q

cotransmitter for ACh

A

VIP

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16
Q

cotransmitter for NE

A

neuropeptide Y

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17
Q

breaks ACh into choline and acetate

A

acetylcholinesterase

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18
Q

parasympathetic effects on the eye [2]

A

contraction of iris (miosis)
contraction of ciliary muscle (accommodation)

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19
Q

parasympathetic effects on cardiovascular system

A

bradycardia

(can reduce peripheral resistance in GI and erectile tissue ONLY via NO)

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20
Q

parasympathetic effects on respiratory system [2]

A

contract muscle of bronchial trees
stimulates secretion of fluids

(exacerbates asthma symptoms)

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21
Q

parasympathetic effects on GI system [2]

A

increase secretions
increase peristalsis

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22
Q

parasympathetic effects on GU system [3]

A

contracts detrusor muscle
relaxes trigone and spinchter
promotes voiding

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23
Q

rate limiting enzyme in production of NE

A

tyrosine hydroxylase

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24
Q

describe the production of NE

A

tyrosine –> dopa (tyrosine hydroxylase)
dopa –> dopamine (dopa decarboxylase)
dopamine –> NE (dopamine-beta-hydroxylase)

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25
Q

the release of NE is […] dependent

A

calcium

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26
Q

transporter that reuptakes NE from the synaptic cleft into the neuron

A

uptake 1

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27
Q

uptake 1 inhibitors [2]

A

cocaine
TCAs

(increase the amount and action of NE in the synapse)

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28
Q

sympathetic effects on cardiovascular system [3]

A

alpha r: increase arterial resistance
beta 2: relax venous smooth muscle
renin secretion stimulated by beta receptors

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29
Q

sympathetic effects on heart [2]

A

beta 1: increased calcium –> increases contractility

increased AV conduction

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30
Q

sympathetic effects on respiratory system [2]

A

beta: relaxes bronchial smooth muscle
alpha: contracts blood vessels of URT mucosa (relieves congestion)

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31
Q

sympathetic effects on GI system [3]

A

alpha: contraction of spinchter
beta: longitudinal smooth muscle relaxation
decreases PNS drive on enteric system

32
Q

sympathetic effects on GU system [2]

A

alpha: contraction of bladder and urethral spinchter for urinary retention
beta: relaxation of bladder wall smooth muscles for urinary retention

33
Q

apocrine sweat glands are driven by […] SNS activity

A

adrenergic

34
Q

thermoregulatory sweat glands are driven by […] SNS activity

A

cholinergic

35
Q

sympathetic effects on the eye [2]

A

alpha: mydriasis
beta: increase aqueous humor

36
Q

metabolic effects of SNS

A

increase lipolysis, glycogenolysis, glucose release, insulin secretion

37
Q

plasma glucose is typically […] during sympathetic discharge

A

increased

38
Q

how does autonomic dysfunction cause orthostatic hypotension?

A

inadequate SNS contraction of vasculature in lower extremities

39
Q

how does autonomic dysfunction cause bradycardia?

A

SNS loss

40
Q

how does autonomic dysfunction cause tachycardia?

A

loss of PSNS

41
Q

a drop in systolic of […] or in diastolic of […] is an abnormal orthostatic BP change

A

systolic >20
diastolic >10

(also considered abnormal if lightheaded/dizzy)

42
Q

2 common causes of orthostatic hypotension

A

volume depletion
ANS dysfunction

43
Q

increase in heart rate >30 points on standing
no drop in BP

A

postural orthostatic tachycardia syndrome (POTS)

44
Q

most common cause of syncope

A

neurally-mediated reflex

“vaso-vagal”, “vaso-depressor”

45
Q

medications for orthostatic hypotension [3]

A

flourinef
midodrine
droxidopa

46
Q

Horner’s syndrome is an example of a […] condition

A

focal autonomic nervous system condition

47
Q

causes of acute ANS dysfunction [2]

A

toxins
drugs

48
Q

are antihistamines cholinergic or anticholinergic?

A

anticholinergic

49
Q

hereditary causes of chronic diffuse autonomic neuropathy [2]

A

familial amyloid polyneuropathy (ATTR)
hereditary sensory autonomic neuropathies

50
Q

acquired causes of chronic diffuse autonomic neuropathy [2]

A

idiopathic
neurodegenerative (parkinson’s)
secondary disorders (diabetes, amyloidosis, autoimmune)

51
Q

most common amyloidosis

A

light chain (AL)

52
Q

acquired types of amyloidosis [2]

A

light chain (AL)
secondary amyloidosis (AA)

53
Q

amyloid deposition damages […] fibers

A

small, unmyelinated

54
Q

hereditary amyloidosis

A

ATTR

55
Q

light chain (AL) amyloidosis is caused by

A

underlying plasma cell dyscrasia

56
Q

inotersen can be used to treat

A

ATTR (hereditary amyloidosis)

57
Q

sympathetic postganglionic neurons release […] as their primary neurotransmitter

A

NE

58
Q

what types of neurons release ACh as their primary neurotransmitter? [3]

A

sympathetic preganglionic neurons
parasympathetic preganglionic neurons
parasympathetic postganglionic neurons

59
Q

only system with exclusive sympathetic innervation

A

systemic vasculature

60
Q

why is it common for small fiber neuropathies to co-occur with autonomic neuropathies?

A

both the small fibers and postganglionic axon of the autonomic system are unmyelinated

thus, predisposed to protein deposition

61
Q

best test for diagnosis of secondary amyloidosis

A

abdominal fat pad biopsy

62
Q

elevated protein and normal WBC on lumbar puncture

A

AIDP

63
Q

elevated protein and elevated WBC on lumbar puncture

A

infection

64
Q

medications used to treat POTS [5]

A

beta blockers
fludrocortisone
ivabradine
erythropoietin
pyridostigmine

65
Q

catecholamine released from the ends of sympathetic fibers

A

NE

66
Q

chief neurotransmitter of the parasympathetic nervous system

A

acetylcholine

67
Q

largest autonomic plexus

A

celiac

68
Q

plexus that supplies the viscera of the pelvic cavity

A

hypogastric

69
Q

plexus located at base of the heart

A

cardiac

70
Q

continuation of the celiac plexus that surrounds the SMA

A

superior mesenteric plexus

71
Q

test that measures the autonomic nerves that control sweating

A

QSART

72
Q

grading of adrenergic impairment requires what tests [2]

A

valsalva maneuver
tilt test

73
Q

systolic murmur can indicate

A

aortic stenosis

74
Q

mid-systolic click can indicate

A

mitral stenosis

75
Q

next best test for a patient with suspected structural cardiac changes

A

transthoracic echocardiogram

76
Q

accounts for 60% of syncope cases

A

neurally-mediated syncope

77
Q
A

:)

BMB Test 1 (17 decks)

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