Neuro Flashcards
(304 cards)
Age-related macular degeneration types and therapies
Dry = sub retinal drusen deposits or pigment changes. Wet = abnormal blood vessels w/ sub retinal fluid/hemorrhage, gray subretinal membrane, or neovascularization (acute over days to weeks). Tx of acute = anti-VEGF inhibitors (prevent neovascular membrane formation), laser, photo
1st line drug for partial seizures
Carbamazepine; regardless of simple or complex
1st line drug for tonic-clonic sz
Phenytoin, carbamazepine, valproate
1st line drug for myoclonic sz
Valproic acid
1st line drug for absence sz
Ethosuximide, blocks T-type Ca2+ channels that trigger and sustain pulsed discharges in thalamic neurons. (2nd = valproate)
Gene defect in Friedreich’s ataxia?
Frataxin gene - mitochondrial protein for respiratory f(x) and Fe homeo. GAA repeat.
Drug after SAH to prevent vascular spasm?
Nimodipine
Viral CSF pattern?
Lymphocytic pleocytosis, normal glucose, elevated protein.
Bacterial CSF pattern?
Neutrophilic predominance, low glucose, high protein.
Early-onset familial Alzheimer’s associated w/ what mutations?
APP (21- Down’s!), presenilin 1 (14), and presenilin 2 (1). Apo E4 w/ late.
Path associated with lacunar infarcts?
Small vessel lipohyalinosis and atherosclerosis ->fluid-filled cavities
Alzheimer’s path
Decreased ACh lvl (deficient choline acetyltransferase) found in basal nucleus. Hippocampus. Neurofibrillary tangles, senile plaques, amyloid angiopathy.
Myasthenia gravis
Circulating Ab’s against post-synaptic Ach receptors -> complement-mediated destruction -> weakness (late in day). Associated with thymoma or thymic hyperplasia.
Two types of dopamine agonists
Ergot compounds (bromocriptine and pergolide) and nonergot compounds (pramipexole and ropinirole).
Phenytoin mech
Blocks Na+ channels and prolongs their rate of recovery. Inhibits high-frequency firing. Tonic-clonic and status.
Triptan mechanism
Serotonin 5-HT1b/5-HT1d AGONISTS that counter release of vasoactive peptides
Migraine mech
Pain due to activation of trigeminal afferents that innervate meninges -> release of vasoactive neuropeptides (substance P and calcitonin gene-related peptide) -> neurogenic inflammation due to vasodilation and plasma protein extravasation. Neuronal sensitization
How does ketamine block morphine tolerance?
NMDA receptor antagonist to block actions of glutamate.
Subfalcine herniation
Cingulate gyrus herniates under falx cerebri –> ACA compression
Uncal herniation
Ipsi oculomotor, ipsi PCA -> contralateral homonymous hemianopsia w/ macular sparing, compression of contra cerebral peduncle -> ipsilateral hemipareses. brainstem hemorrhages
Dmg to putamen vs. globus pallidus
Putamen initiates movt so lesions –> tremor, bradykinesia, and rigidity. GP external dmg = less movt. Internal dmg = excessive motion/movt. Think of damage to globus as the normal pathways through them b/c they are inhibited in their pathways.
Nucleus ceruleus?
NE-secreting neurons for flight or fight. Dorsal pons.
Raphe nuclei?
Serotonergic neurons. Sleep-wake, lvl of arousal. Lesion -> insomnia and depression. Sir Raphe the sleepy.
Nucleus basalis of Meynert?
Cholingergic cells. Decreased amounts in Alzheimer’s disease. Cholling Mr. Meynert?