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Dog shit extra slides that shouldn't fucking exist Flashcards

(105 cards)

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1
Q

Describe how NMJ functions

A
  • Action potential reaches neuron terminus
  • This activates voltage gated calcium channels
  • ACH is released and attaches to nicotinic-ACH receptors on postsynaptic surface
  • Stimulates Muscle contraction
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2
Q

How does Botulinum Toxin stop NMJ?

A

Stops ACH from being released from the end motor neuron

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3
Q

What is used to treat Myasthenia Gravis

A

Acetylcholinesterase Inhibitors
and
Immunosuppressants

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4
Q

What is the occurrence of individuals with respiratory failure who also have Myasthenic crisis?

A

20%

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5
Q

In NCS motor studies, what gives rise to Amplitude and Conduction?

A

Axons - Amplitude
Conduction - Myelin

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6
Q

What are used to treat Guillain Barre syndrome?

A

IVIG, Analgesia, and ventilatory support

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7
Q

Describe Relapsing Remitting MS (1/4)

A

85% of MS cases
Acute periods of relapse then recovery
Symptoms don’t worsen during recovery phase
Can progress into Progressive MS

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8
Q

Describe Secondary Progressive MS (2/4)

A

Relapsing Remitting may progress to this
Symptoms steadily worsen

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9
Q

Describe Primary Progressive MS (3/4)

A

Most severe type of MS
10-15% of MS patients
Must never have had relapse

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10
Q

Describe Progressive Relapsing MS (4/4)

A

Steady progression of disease with periods of acute relapse

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11
Q

What are the Input (afferents) to the Neocortex?

A

Ascending info from Thalamus
Ascending info from Sub-cortical structures
(Hypothalamus, basal ganglia, brainstem)
Commissural and Association fibres from pyramidal neurons

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12
Q

What are the Output (efferents) from the Neocortex?

A

Always excitatory via pyramidal cells
Thalamus
Basal ggl.
Brainstem nuc.
Spinal cord
Contralateral hemisphere
Ipsilateral hemisphere

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13
Q

Where is the Olfactory cortex found?

A

Anterior Temporal Lobe

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14
Q

What are some Visual Agnosias?

A
  • Optic Ataxia - struggle to locate objects in space (grab objects)
    What-Where pathway disorientation
  • Prosopagnosia - can’t recognise faces
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15
Q

What are some Auditory Agnosias?

A

Wernicke’s and Broca’s aphasias
Amusia - difficulty detecting pitch or recalling music

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16
Q

What are the 3 layers of the Cerebellar cortex from external to internal?

A

Molecular
Purkinje Cell
Granule Cell

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17
Q

What are some notable traits about Purkinje cells?

A

Only found in Cerebellum
Inhibitory Neurons
Can be damaged by alcohol and lithium
Loss found in autistic children

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18
Q

Crista Galli is a part of what bone?

A

Ethmoid

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19
Q

What may be caused by a lesion of one of the somatosensory association cortexs?

A

Amorphosynthesis
(Unilateral inattention to sensory input)

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20
Q

What are the 3 compensatory responses?

A

Muscle proprioceptors
(detect changes in muscle length and tension)
Sense of balance
(detect movement of head ie. falling)
Visual inputs
(detect movement in visula field)

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21
Q

How many days are needed to wash out MOAI’s before using other antidepressants?

A

14 days

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22
Q

What is the name of a reversible MAOI
AND
how does it work?

A

Moclobeminde
Reversible inhibition of MAO type A

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23
Q

What is the relation between Tricyclic Antidepressants and ACH receptors?

A

Tricyclics have antimuscarinic activity that blocks activity of the muscarinic ACH receptor so reduce intestinal mobility

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24
Q

Name a drug related to Tricyclics

A

Trazodone

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25
What is the most toxic SSRI for overdoses?
Citalopram
26
Name some common SNRI's
Duloxetine Venlafaxine
27
Name a common presynaptic alpha2-adrenoreceptor antagonist AND what is it used for?
**Mirtazapine** Depression, anxiety, PTSD (antidepressant)
28
What are the side effects of Mirtazapine in Low and High doses?
LOW doses - Drowsiness HIGH doses - Stimulant effect
29
Name an antipsychotic that has some antidepressant properties
Risperidone
30
How do tricyclics help with pain management?
Block re-uptake of Noradrenaline and Serotonin into the nerve endings and increase their levels in the pain control pathway
31
What are 3 commonly used antidepressants?
Amitriptyline (Tricyclic) Nortriptyline (Tricyclic) Duloxetine (SNRI)
32
What is Duloxetine also licensed for?
Diabetic Neuropathy
33
What are some symptoms of Depression?
Lowered appetite Insomnia Low energy Loss of libido Social withdrawal
34
What are some examples of early life experiences that may increase a person's vulnerability later in life?
Poor parent-child relationship Marital discord / divorce Neglect Physical and sexual abuse
35
The rate of depression in women, who before age 11, had lost their mother and who also experienced a severe recent loss is how much greater?
x3 higher
36
Depression is approximately ___ more common in patients with a chronic illness
2 to 3 times
37
Major depression is associated with ___ increased risk for cardiac mortality among patients hospitalised for MI
2 to 4 times
38
Define Penumbra
Area of salvageable damage
39
What are the 3 Watershed areas?
Most vulnerable to hypoperfusion Cortical Border Zone between ACA and MCA Internal Border Zone between LCA and MCA Cortical Border Zone between MCA and PCA
40
What is an ABCD2 Assessment AND how do you score it?
7 point score to predict early stroke risk post TIA Points for: Aged 60 or above [1] BP systolic >140 and/or diastolic >90 [1] Unilateral weakness [2] Speech disturbances w/o weakness [1] Duration of symptoms in mins, >60 [2], 10-59 [1] Diabetes [1]
41
What are the 5 S's of Stroke Mimics?
Seizures Sepsis Syncope SOL (tumour, subdural) Somatisation
42
What are some symptoms of General Anxiety Disorder?
Restlessness Easily fatigued Difficulty concentrating Irritability Muscle tension Disturbed sleep
43
What are the 1st - 3rd line drug treatments for Generalised Anxiety Disorder?
1st line - SSRI e.g. sertraline 2nd line - Alternative SSRI or SNRI 3rd line - Consider Pregabalin
44
Define Delusions
A false, fixed, strange, or irrational belief that is firmly held. Not normally accepted by other members of the same culture or group (excuse for religion)
45
Define Hallucinations
Sensory perception without an appropriate stimulus
46
What are the 5 notable structures in the Cerebellum?
Ant. Lobe Primary Fissure Post. Lobe Posterolateral Fissure Flocculonodular Lobe
47
What is the function of the 3 lobes of the cerebellum?
Ant. Lobe - Spinocerebellum Post. Lobe - Cerbrocerebellum Flocculonodular Lobe - Vestibulocerebellum
48
Vestibulocerebellum receives input and sends output to where?
Input - Vestibular & Visual areas Output - Vestibular nuc.
49
Spinocerebellum receives input and sends output to where?
Input - Spinocerebellar & auditory, visual, vestibular systems & sensorimotor cortex Output - Vermis to fastiglial nuc. to vestibular & reticular formation of pons and medulla
50
Spinocerebellum consists of what structures?
Vermis of post. and ant. cerebellum + adjacent intermediate zones on both sides of vermis
51
Cerebrocerebellum receives input and sends output to where?
Input - Cerebral motor cortex & adjacent premotor & somatosensory cortices Output - Dentate nuc. to thalamus to motor and premotor cortices
52
Cerebrocerebellum consists of what structures?
Lateral zones of Cerebellar hemispheres (pink/flesh)
53
What are the input and output neurons of the Cerebellum?
Input - Climbing & Mossy Output - Purkinje
54
What are the 4 nuclei of the Cerebellum?
Dentate Emboliform Globose Fastiglial
55
What is the primary role of the Cerebellum?
Thought to be to supplement and correlate activities of other motor areas
56
What are the clinical features of Cerebellar damage?
Hypotonia Ataxia Dysarthria Nystagmus Myoclonus
57
What are the 2 parts of the Membranous Labyrinth?
Auditory part - Cochlea Vestibular part - Otolith organs & Semicircular canals
58
What cells are in the saccule?
Hair cells
59
What 2 structures make up the Otolithic Organs?
Saccule & Utricle
60
What is the difference in function between the Otolith organs and the Semicircular canals?
Otolith organs - Detect gravity & head tilt Semicircular canals - Detect head rotation
61
What does the Utricle detect?
Horizontal acceleration
62
What does the Saccule detect?
Vertical acceleration
63
Describe Mechanotransduction in Hair cells
---SEE DIAGRAM--- Cilia + kinocilium provide direction info Movement of otolithic membrane bends these structures Movement will open hair cell cation channels
64
How do the semicircular canals detect angular acceleration (head rotation movements)?
Hair cells are clustered in sensory epithelium called **Crista Ampullaris** These hair cells project into **gelatinous Cupula**, all orientated the same way As head rotates canal moves but endolymph stays put, bending the hair cells to either excite or supress transmitter release
65
What is the path of axons from Otolith organs?
First project to the Lateral Vestibular Nucleus They then project via vestibulospinal tract to Spinal Motor neurons - POSTURE
66
What is the path of axons from Semicircular canals?
First project to the Medial Vestibular Nucleus They then project via MFL to Motor nerves of trunk and neck muscles - keeps head straight as body moves
67
Describe the Vestibulo-Ocular reflex
Semicircular canals control eye movements Dirrect stimulation of ampullary nerves elicits specific eye movements
68
What is a potential cause of Meniere's disease?
XS accumulation of endolymph and damage to hair cells
69
What causes Vertigo?
Debris from otolithic membrane adhering to cupula in ampulla of post. semicircular canal May also be due to lesions of vestibular aspect of CN VIII, or central lesions affecting brainstem vestibular nuclei
70
What is a risk factor for Spina Bifida AND how can it be minimised?
Low levels of Folic Acid in early pregnancy Take 400 micrograms daily
71
What are possible complications of Spina Bifida?
Permanent spinal injury from lesion downwards L1 lesions likely to be wheelchair bound Sacral lesions less likely to walk Bladder and bowel dysfunctions Hydrocephalus + Chiari malformations
72
What is the difference between a Chiari 1 malformation and a Chiari 2?
Chiari 1 - Downward placement of cerebellar tonsils Chiari 2 - Downward placement of cerebellum, brainstem, and 4th ventricle
73
What is a Syringolmelia?
Fluid filled cyst (syrinx) forms within the spinal cord
74
What **leg mobility functions** would be lost in an L4 spinal cord injury?
Knee flexion Hip extension Ankle dorsiflexion Ankle inversion Greater toe flexion
75
What is a significant risk for those who are less able to mobilise AND how may it be prevented?
Pressure sores Graded 1- 4 (4 being the worst) Regular repositioning and specialist mattresses / cushions
76
How may we treat Neurospaciticy?
Regular Botulinum Toxin injections to relax muscles Splints to keep limb in more comfortable position
77
How may we treat Neuropathic pain?
Chronic pain medication e.g. Gabapentin / Pregabalin / Amitriptyline / Duloxetine Dorsal column stimulator implants can block pain signals
78
What is life threatening issue that may affect those with T6 or above injury AND what are its symptoms and managements?
**Autonomic Dysreflexia** Pounding headache, flushed skin above level of SCL, HT, low HR Give sublingual **Nifedipine**
79
What is the Disability paradox?
The assumption (made by the abled) that individuals with a disability have a lower quality of life This is NOT true
80
What specifically is being tested in the Cornea reflex?
Trigeminal sensory pathway Facial motor pathway
81
What are the only CN's with and Parasympathetic function?
III, VII, IX, X
82
Name all brainstem nuclei
^^^
83
What class of drug is **Metformin**?
Biguanide
84
What are the side effects of **DDP-4 inhibitors** (gliptans)?
- Headache - Dizziness - Pancreatitis
85
What is **HONK**?
Hyper Osmolar Non-Ketotic coma
86
What is **MALA**?
Metformin Associated Lactic Acidosis
87
Describe what **condition** is present in each NCS
88
What are some functions of the **Reticular Formation**?
89
Describe the **main features of MS**
90
Roughly describe the 4 types of MS
91
What are the treatment options for MS?
92
What is **Prosopagnosia**?
**Face blindness** (can't recognise faces)
93
What are the 3 layers of the **Cerebellum**?
94
What are the different types of spinocerebellar tracts?
**Posterior spinocerebellar tract** - proprioceptive and tactile info from lower limb **Cuneocerebellar tract** - proprioceptive and tactile info from upper limb **Anterior spinocerebellar tract** - relays ascending proprioceptive and decending motor info to the cerebellum for refined motor output
95
What **muscles** are associated with the **1st** pharangeal arch?
96
What **muscles** are associated with the **2nd** pharangeal arch?
97
What **muscles** are associated with the **3rd** pharangeal arch?
**Stylopharangeus**
98
What **muscles** are associated with the **4th** pharangeal arch?
99
What **muscles** are associated with the **6th** pharangeal arch?
**Laryngeal muscles** (except cricothyroid)
100
Describe **Primary brain injury**
101
Describe **Secondary brain injury**
102
When **shouldn't** you discharge a TBI patient?
103
Name two antibiotics that can be used for **UTI's**
Trimethoprim Fosfomycin
104
What are two common **bacteria found in urine**?
E.coli Klebsiella
105
What is done to treat **DKA in clinical setting**?

Neuro (14 decks)

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